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Goodwill and Intangible Assets | 12 Months Ended
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Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Intangible Assets | 5.GOODWILL AND INTANGIBLE ASSETS The changes in the carrying amount of goodwill for the years ended December 31, 2024 and 2023, are as follows (in thousands):
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | 2024 | ​ | 2023
​ |  | Cardiovascular | ​ | Endoscopy | ​ | Total |  | Cardiovascular | ​ | Endoscopy | ​ | Total
Goodwill balance at January 1 | ​ | $ | 382,240 | ​ | $ | — | ​ | $ | 382,240 | ​ | $ | 359,821 | ​ | $ | — | ​ | $ | 359,821
Effect of foreign exchange | ​ |  | (1,623) | ​ |  | — | ​ |  | (1,623) | ​ |  | 883 | ​ |  | — | ​ |  | 883
Additions and adjustments as the result of acquisitions | ​ |  | 65,897 | ​ |  | 16,997 | ​ |  | 82,894 | ​ |  | 21,536 | ​ |  | — | ​ |  | 21,536
Goodwill balance at December 31 | ​ | $ | 446,514 | ​ | $ | 16,997 | ​ | $ | 463,511 | ​ | $ | 382,240 | ​ | $ | — | ​ | $ | 382,240
​ Total accumulated goodwill impairment losses aggregated to $8.3 million as of December 31, 2024 and 2023. We did not have any goodwill impairments for the years ended December 31, 2024, 2023 and 2022. Other intangible assets at December 31, 2024 and 2023, consisted of the following (in thousands):
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2024
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 31,489 | ​ | $ | (12,824) | ​ | $ | 18,665
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,994) | ​ |  | 256
License agreements | ​ |  | 11,557 | ​ |  | (9,125) | ​ |  | 2,432
Trademarks | ​ |  | 47,613 | ​ |  | (24,177) | ​ |  | 23,436
Customer lists | ​ |  | 57,933 | ​ |  | (36,223) | ​ |  | 21,710
Total | ​ | $ | 151,842 | ​ | $ | (85,343) | ​ | $ | 66,499
​
​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​ | ​
​ | ​ | December 31, 2023
​ | ​ | Gross Carrying | ​ | Accumulated | ​ | Net Carrying
​ |  | Amount |  | Amortization |  | Amount
Patents | ​ | $ | 28,877 | ​ | $ | (10,916) | ​ | $ | 17,961
Distribution agreements | ​ |  | 3,250 | ​ |  | (2,919) | ​ |  | 331
License agreements | ​ |  | 11,142 | ​ |  | (8,327) | ​ |  | 2,815
Trademarks | ​ |  | 35,135 | ​ |  | (20,804) | ​ |  | 14,331
Customer lists | ​ |  | 40,367 | ​ |  | (33,921) | ​ |  | 6,446
Total | ​ | $ | 118,771 | ​ | $ | (76,887) | ​ | $ | 41,884
​ Aggregate amortization expense for the years ended December 31, 2024, 2023 and 2022 was $65.6 million, $56.1 million, and $48.4 million, respectively. Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2024 (in thousands):
​ | ​ | ​ | ​
Year ending December 31, |  | Estimated Amortization Expense
2025 | ​ | $ | 83,747
2026 | ​ |  | 73,155
2027 | ​ |  | 69,188
2028 | ​ | ​ | 67,790
2029 | ​ |  | 56,115
​

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Topic 350 -SubTopic 30 -Name Accounting Standards Codification -Publisher FASB -URI https://asc.fasb.org/350-30/tableOfContent Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Topic 350 -SubTopic 20 -Name Accounting Standards Codification -Publisher FASB -URI https://asc.fasb.org/350-20/tableOfContent + Details
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