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Goodwill and Intangible Assets | 3 Months Ended
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Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Intangible Assets | 5. Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the three-month period ended March 31, 2022 is detailed as follows (in thousands): ​
​ | ​ | ​ | ​
​ |  | 2022
Goodwill balance at January 1 | ​ | $ | 361,741
Effect of foreign exchange | ​ |  | (285)
Goodwill balance at March 31 | ​ | $ | 361,456
​ Total accumulated goodwill impairment losses aggregated to $8.3 million as of March 31, 2022 and December 31, 2021. We did not have any goodwill impairments for the three-month periods ended March 31, 2022 and 2021. The total goodwill balance as of March 31, 2022 and December 31, 2021 was related to our cardiovascular segment. ​ Other intangible assets at March 31, 2022 and December 31, 2021 consisted of the following (in thousands): ​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | March 31, 2022
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 26,691 | ​ | $ | (8,788) | ​ | $ | 17,903
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,569) | ​ |  | 681
License agreements | ​ |  | 12,725 | ​ |  | (8,098) | ​ |  | 4,627
Trademarks | ​ |  | 30,238 | ​ |  | (15,920) | ​ |  | 14,318
Customer lists | ​ |  | 34,919 | ​ |  | (31,549) | ​ |  | 3,370
Total | ​ | $ | 107,823 | ​ | $ | (66,924) | ​ | $ | 40,899
​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2021
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 26,349 | ​ | $ | (8,315) | ​ | $ | 18,034
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,519) | ​ |  | 731
License agreements | ​ |  | 12,663 | ​ |  | (7,768) | ​ |  | 4,895
Trademarks | ​ |  | 30,242 | ​ |  | (15,256) | ​ |  | 14,986
Customer lists | ​ |  | 34,985 | ​ |  | (31,195) | ​ |  | 3,790
Total | ​ | $ | 107,489 | ​ | $ | (65,053) | ​ | $ | 42,436
​ Aggregate amortization expense for the three-month periods ended March 31, 2022 and 2021 was $12.2 million and $12.5 million, respectively. ​ We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. During the three-month period ended March 31, 2022, we identified indicators of impairment associated with certain acquired intangible assets based on our qualitative assessment, which led us to complete an interim quantitative impairment assessment. The primary indicator of impairment was our planned divestiture of the STD Pharmaceutical Products Limited (“STD Pharmaceutical”) business acquired in our August 2019 acquisition of Fibrovein Holdings Limited. On April 30, 2022, we completed the divestiture of Fibrovein Holdings Limited, in exchange for the termination of our obligations arising from the acquisition transaction in August 2019 and the purchaser’s agreement to make potential future payments upon a qualifying disposition of the STD Pharmaceutical business. We recorded an impairment charge for the carrying value of $1.7 million of intangible assets during the three months ended March 31, 2022, all of which pertained to our cardiovascular segment. ​ We did no t identify indicators of impairment in any intangible assets based on our qualitative assessment for the three-month period ended March 31, 2021. ​ Estimated amortization expense for the developed technology and other intangible assets for the next five years consisted of the following as of March 31, 2022 (in thousands): ​
​ | ​ | ​ | ​
Year Ending December 31, |  | Estimated Amortization Expense
Remaining 2022 | ​ | $ | 35,932
2023 | ​ |  | 46,894
2024 | ​ |  | 43,959
2025 | ​ | ​ | 42,185
2026 | ​ |  | 31,634
​

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -URI http://asc.fasb.org/topic&trid=2144416 + Details
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