Medistim Aktie

A very good morning from sunny Oslo, and welcome to Medistim's presentation of our first quarter 2026 financial results. My name is Kari Krogstad, and together with CFO, Thomas Jakobsen, who will together take you through the results.

Before getting into the highlights, we like to start this presentation just reminding ourselves on Medistim's track record and also just highlighting that our growth over the past 10 years in sales has been close to 11%. And on our EBIT, we have been growing close to 15% over the past 10 years in a CAGR way. So that's a reminder of our promise to continue to deliver profitable growth.

Let's now dive into the first quarter. So I'm very happy to be able to present another record sales quarter from Medistim. So for the first time, we are exceeding NOK 200 million in revenues. That means 11.1% growth in NOK. We can see that we have some negative currency effects here. So if we adjust for this, we will see that the currency-neutral sales development is actually up at 18.5%.

And further, looking at sales of our own products, which is, of course, the strategic product portfolio and the most important part of our business, we see that this is up a solid 28.8%. All regions are contributing to this result. Americas is up 30.9% currency neutral this quarter. EMEA up 11.5% and Asia Pacific have a tremendous 57.5% growth. We're also noting that our third-party products is down by 30.2%. And we will remember that the beginning of last year was very, very strong due to sales to new hospitals in Norway, and we couldn't expect that to be repeated in this quarter.

When we look at the EBIT at NOK 57.1 million, that is also a very, very strong operating result. It's actually the second-best operating result ever, just beaten by the same quarter last year. And if we are adjusting for currency effects here, we would actually see close to 4% improvement in the EBIT for this quarter.

We know that the U.S. tariff is making an impact this quarter, so impacting our gross margin, and that's also the EBIT margin. The margin remained strong at 28.3%, a little bit lower than the same quarter last year, but still at the high level that we would like to see. Of course, very much driven by the sales -- strong sales of our own products.

We will note and have some explanation to some higher operating expenses this quarter. Of course, some of that is connected to the establishment of the direct operation in Japan. We are also seeing increasing higher activity levels throughout our sales organization, which is a very deliberate effect that we want to see. And we're also taking some expenses on an IT infrastructure upgrade.

The general assembly yesterday decided that we will pay out a dividend of NOK 8 per share. So that will be a total of NOK 146.2 million.

So with that introduction, I will leave the word to Thomas.

Thank you very much, Kari, and good morning, everyone. I will take us through the first quarter profit and loss balance sheet and cash flow. And going directly to the profit and loss, Kari will take us through total revenue splits per region and per product. So I will not go into that detail. However, we do have a weaker gross margin in percent this quarter, and this is explained by our sales channels.

We have communicated before that our margin is very much dependent on the sales channel we are selling through, either through distributor network or if we are direct in a market, and there's also variances between different regions. So for this first quarter, relatively speaking, we have strong sales to our distributor network, but we also have very strong sales to our APAC region, which affects gross margin and gives us a little bit weaker gross margin as such, not much, but it is a little bit lower than our margins in the U.S. market.

And also, what Kari mentioned is the tariff. The U.S. tariff was not implemented in the first quarter 2025. We have full effect of that in 2026, and it amounts to NOK 5.1 million. And that was an expense, obviously, we did not have last year. Salary and social expenses are at the same level more or less as last year, but we do have additional operating expenses this quarter, and that's related to a lot of activities, which Kari has touched upon. We do have this IT infrastructure project, which we also spoke about in the fourth quarter. And in this quarter, we expensed NOK 1.5 million related to that project.

We also have the establishment of our direct operation in Japan, and it has -- that has added another NOK 1.5 million expenses to our P&L. We also had recruitment expenses. We recruit and grow the business continually and the recruitment expenses for this quarter was NOK 1 million higher compared to last year. And last but not least, we do have a high level of commercial activities, which was NOK 3 million higher this quarter compared to last year, and it's very much travel and face time with customers we've been talking about.

Last but not least, we also have an agent commission for this quarter. This is not very normal in Medistim because we either sell through distributor or our direct sales network. However, some hospitals require that they have a contract directly with Medistim, and that's happened this quarter. And these contracts are then controlled through letter of credits, then -- which controls the cash flow from the hospital to the manufacturer and also controls that the hospitals are actually getting the delivery and secure the delivery that they have been promised. And this happened in the first quarter, and then we have an agent commission then of NOK 2.1 million, which are then the return commission to our distributor for the services that they provide.

So given all this, our EBITDA ends at NOK 63.3 million, a little bit weaker than first quarter last year that ended at NOK 64.7 million. Depreciation increases. We do have additional lease obligations, which is the reason for the increased depreciation. And our operating profit ends at NOK 57.1 million and an EBIT margin of 28.3%. That's weaker than the first quarter last year. But I think, looking at the big picture of the fiscal year 2025, our EBIT margin was 28%. So we are well in line with what we communicated earlier that our EBIT margin should be in the high 20% area.

Net finance is negative. We have experienced a strengthening of the Norwegian krone, especially towards U.S. dollars, but also towards euro. So the net effect of finance is negative by NOK 5.5 million. And profit before tax then ends at NOK 51.5 million and profit after tax ends at NOK 40.3 million.

Looking at our balance sheet. Our intangible assets increases. We have 2 major development projects ongoing, which are recognized as an asset in our balance sheet, but we also have this IT infrastructure project, which I mentioned in the P&L. Basically, what we're doing with the IT infrastructure project is that mainstream code and setup are expensed and Medistim unique code and setup is recognized as assets. So it's a combination of those 2.

Inventory level, same level as the end of the year. So the increase in our working capital is related to accounts receivables that increases from NOK 86 million to NOK 104 million. Cash position is solid, ends at just under NOK 210 million, a little bit below the cash position by the end of the year, and I will comment that a little bit further later on in the cash flow statement.

Equity is strong, ends at over 74% and we have no interest-bearing bank debt, haven't had that for many years. Our long-term liabilities are related to 2 things. We have lease obligations of a total of NOK 46.2 million, where NOK 11.6 million is short term. And the deferred revenue is extended warranty contracts, 2- to 3-year contracts, which then -- revenue are then recognized over that time period.

All in all, we do have now decided that we are going to pay out a dividend, and that will be paid, I think, estimated 18th of May. That will obviously affect our equity when we are then closing the second quarter. NOK 146 million, so will then reduce our total equity and equity percent but it's still a solid equity as such.

Earnings per share, still solid, more than NOK 2 per share this quarter. And we do have also a strong equity position, as you can see, 70.9% by the end of the year, increased now to 74.3%.

Cash flow, we do experience that our cash flow from operation is relatively weak this quarter, and there are reasons for that. First of all, we have prepayments of income tax of NOK 14.1 million. We do have the increase in working capital related to increase in our accounts receivables. But we also have what is called here other, which are accrued expenses in 2025 that we now have paid out in the first quarter. And a lot of this is related to commissions and also yearly bonuses that has been achieved based upon the results that Medistim delivered in 2025. So net cash from operation is then NOK 7.2 million.

In addition to that, we have investments related to our development project and the IT infrastructure project and also we have paid lease obligations of NOK 2.9 million. So net negative cash flow is then NOK 2.3 million, which then leaves us with a cash position pretty much the same as we entered the year into with, so NOK 210 million.

And with that, I leave the word to Kari. Thank you.

Yes. And let's then dive into our business segments update, starting with the flow and imaging systems sold in units. So this is obviously our most important part of the product portfolio since it's our absolutely unique product offering. We are the only company out there providing combined flow measurements and high-frequency ultrasound technology in the same system, which is providing really high value both to cardiac surgeons and to vascular surgeons. And as you know, we are selling this product that's about double the price of a flow-only system. So this is very important for us to see a continued uptake and adoption of this technology.

For the quarter, we see it's a good quarter for us. It's -- we sold 28 systems this quarter. EMEA and Asia Pacific sold more than the same quarter last year. Americas down by 4 units this quarter. These typically vary from quarter to quarter. But all in all, a strong quarter for flow and imaging unit sales.

When we are selling these systems, the imaging probe sales tend to follow, and we're also seeing, therefore, strong imaging probe unit sales this quarter. And here, Americas is up by 2 units, EMEA up by 7 and Asia Pacific down by 1 unit.

When we look at the flow-only systems, it's also very reassuring to see that this is also growing. So strong flow system unit sales this quarter, up 8 units quarter-over-quarter. And Americas is up. EMEA is a bit down here. We recognize that they had the higher flow and imaging sales. So this tend to sort of level out a little bit. And then we're seeing that Asia Pacific growth by 10 units this quarter, and this is very much driven by growth in our sales to China.

When it comes to flow probes in units, we see that it's a very strong continuation of growth here, so up 27% this quarter and a really strong contribution from all the territories. And as we know that the strong capital system sales are driving the probe sales across all of these regions.

Looking a little bit more into the regions, starting with Americas. So Americas this quarter delivered sales revenues of NOK 84.8 million. And if we adjust to the same currency as we had last year, we look at an underlying growth of 30.9% for the quarter. As we know, the U.S. is the majority of Americas and looking at U.S. in isolation, the currency-neutral growth was 33%. And we have increased our prices significantly in the U.S. And the growth this quarter, we see that about 50% of the 33% is coming from price increases. It's then very reassuring to see that we have good system volume sales as capital, although not as high as the same record quarter last year and also very strong flow probe volume growth at 46%.

Canada has a little bit weaker quarter in the beginning of this year, while the Latin American distributors delivered a strong quarter, but of course, from a much lower base.

Diving a little bit further into the U.S. So we can see here in the table, the system sales and also the outplacements on PPP or lease contracts. And the total number of units that we have then sold or outplaced this quarter is 14 versus 18 last quarter last year. So we're seeing this fewer number of systems sold, but we also see strong sales of consumables to the capital customers.

If we look in the second table, the number of procedures from flow probes to capital customers, we see that, that is growing by the high 35%. We're also seeing very high growth of imaging probes to capital customers of 15%. So new customers are increasingly coming in as capital accounts. And we also see that some of the current PPP or lease customers tend to convert to capital. So this is a trend that is continuing.

To the right in this slide, we have split out the flow procedures, splitting out the cardiac part of these procedures and the vascular part. So now we can follow the development of flow procedures to cardiac here highlighted in orange, either by year or by quarter. And this means that it's very easy to calculate the penetration or the adoption of our technology in the U.S. in CABG. So the cardiac number for 2025 is about 80,000 procedures. And then considering a market of around 200,000 procedures, that leads us to a share of 40% covered by Medistim in the U.S. CABG market. So hopefully, this would be useful to follow going forward.

Moving on to Asia Pacific. So here, we're delivering NOK 42.7 million in sales, making this currency neutral, the increase is actually 57.5%. And we see that the sales to China is making up the majority of this and growing as high as 74.6% for the quarter. And we have continued to explain that we have to expect quarterly variations in our sales to China because we do have, of course, sales office with our own staff, but we still rely on local distributors and agents, and that will inevitably result in some quarterly variability.

Japan, it is a new era for us in Japan, and Q1 was the final quarter where we're selling through a distributor there. So it was on the low side at NOK 2.7 million, much lower than the same quarter last year. But this also means that there will be no inventory buildup in the distribution channel as we saw in China when we went direct there. So we know that when we are starting to sell from the second quarter onwards, that will be through our own team, and there should be no unexpected inventory issues going forward.

We also see this quarter quite strong contribution from the other Asia Pacific distributors, up 105% and contributing then in total with NOK 14.7 million. In Europe and Middle East, the region delivered NOK 52.1 million in sales in the first quarter. Currency neutral, this corresponds to an increase of 11.5%. We note that our direct markets delivered sales in line with the prior year. So no big change there, while the distributor sales is actually providing the growth contribution this quarter, going up 26% currency neutral.

And just thinking back at the EMEA performance also through 2025, varying quite a lot. Direct markets from time to time, contributing very strongly and in other quarters, a bit weaker. So I expect to see a bit variation going forward here as well. But really good news that we, in the first quarter, are already growing by 11.5% currency neutral. That's very encouraging.

The third-party products, as mentioned in the introduction here, the revenue is down 30%. And we are reminded that the first quarter last year represented an exceptionally strong comparable because we sold a lot of ophthalmology products to 2 new hospitals in Norway. So we could not plan for or expect to repeat that sales in this quarter. Other than that, we have a highly diversified product portfolio, and it's Mentor, Icare, and A.M.I, which are the biggest contributors in the whole portfolio.

This table is just summarizing the growth in NOK from the direct markets and also from the distributor parts and regions. So I will not go through the details here. Of course, we are following closely the development of the vascular sales since this is the new market that we are establishing a position in. In this specific market, we see that growth is missing in the vascular segment. It's just 1% up from the same quarter last year. We see that the cardiac sales growth was 24.5%. So that's really at the high side and is then, of course, responsible for being the driver of the total growth this quarter.

Still vascular sales is accounting for 17% of our own product sales, so which is -- it's not a bad proportion. It was a little bit higher than when we looked at the 2025 numbers. But here, we are just expecting the vascular growth to continue and yes, going forward will be in line with what we've seen in previous years.

We also follow the split of flow portfolio versus the imaging product portfolio closely. And we can see this quarter that both the flow products and the imaging products are contributing nicely to the total growth, 23% from the flow products and 12.6% from the imaging products. So that is a solid performance as well.

Closing up here now, taking a look at the recurring versus capital revenues. And we can see that this quarter, we are seeing 20% growth in our recurring revenues, which is quite in line with also how the capital revenues are growing. And the last 12 months takes us to a 70% share of recurring revenues of the total, which is quite in line with the historic levels.

Then a few comments on our strategy. Yes. Just to go through this really quickly, we have a strong position in the coronary bypass segment or the cardiac segment. And we have some markets with really high market share with our Medistim technology, Japan, China, the Nordic countries, the German-speaking countries and other European countries as well with really high share up to 80% to 90% on the procedures covered. And here, it is important for us to continue to convert the dominant flow-only installed base to a flow and imaging installed base. So this is gradually increasing and ongoing.

We are also working to grow our adoption in what we regard as underpenetrated markets, including the U.S. at 40%. Of course, it's growing, but still regarded as underpenetrated in our view. And clinical marketing, the studies that we are doing, really critically important in order to get that traction.

Flexible pricing and business models are important in some particular areas. We have mentioned India before. There are other areas also where we are finding different business models and ways of making our products available and affordable to the customers. So that's part of our strategy. And as I mentioned, building a position in vascular has been a focus for quite some time already, and we are getting traction there.

Last but not least, to expand our direct market coverage and getting closer to our customers, that leads us into the change that we announced the 2nd of February this year that we're opening our direct sales office in Japan. So as of 16th of March, we are direct. We have now a very solid team in place. We have 10 employees there and a very experienced leader with background from the vascular area, which is really very important and provides optimism in terms of breaking into a vascular market also in Japan.

We know that we -- Japan is the strongest market for us in terms of the market penetration, 90% of the CABG surgery procedures are already supported with our technology. And the question is then how to continue this growth. So by getting closer to the end users, we want to get high traction of the conversion from flow-only systems to flow and imaging systems. Of course, we get, let's say, the one-off effect of capturing the distributor margin. So that's also important. And then we will then seek to untap this potential from vascular procedures as well.

So last year, we had sales through our Japanese distributor of about NOK 21 million. And that gives some idea about what we could expect for this year, taking into account that the distributor margin would be now going to Medistim.

As also mentioned in the previous quarterly presentation, that related to the first quarter, I want just to remind that we are now sponsoring a new randomized clinical trial in CABG surgery, the so-called SMARTFLOW trial. And being a large randomized clinical trial comparing the use of flow technology versus no use of flow technology, this could be a breakthrough into providing the evidence to make our technology being eligible for guideline inclusions in the United States, which is the country where we are lacking that kind of support.

And the lead investigator of the trial, Professor Mario Gaudino, well known, really one of the -- well, I would say, the stars on the CABG heaven at this time. He was also the first author of the circulation paper that we have been referring to many, many times, which is an absolutely critical consensus paper stating that this group of highly renowned surgeons are saying that TTFM should be used in every CABG case. But this paper is also concluding that there is a lack of randomized clinical data, and this is now the project that they want to go through.

So we know that the first patients have been enrolled in this trial. It is going to be 1,242 patients enrolled. And there will only be Medistim's MiraQ flow measurement system that will be used, that will be mandatory. And then we will, of course, also encourage the surgeons to use the imaging component while this is not mandatory. It will be a relatively big trial with 20 centers in U.S., Canada, Europe and Asia, so good coverage there. And the goals of the study to begin with is to determine whether TTFM reduces the rate of graft failure. This will be checked within 1 to 3 months of the surgery, and it's going to be documented by coronary CT angiography.

Then the idea is that this provides a platform to continue the study and evaluate the impact of TTFM on the longer-term clinical outcomes. Then we're talking about myocardial infarction, repeat revascularization, survival and quality of life. And these are the outcomes that are relevant for guidelines considerations. So we really believe and hope that the whole -- the platform study will be prolonged into this long-term clinical outcomes study.

So exciting days. Our enrollment here, of course, it's a scientifically independent trial, but we are making a limited financial contribution of USD 500,000, which will be supporting the study over the course of the trial.

At the side of, of course, the main objective, which is to provide this evidence is also providing us with an opportunity to facilitate upgrade of the imaging at the sites that are currently not imaging users. So that's, let's say, a very interesting business opportunity. And then we will also encourage and help the centers to get hold of the newest INTUI software. So this is also a great opportunity.

Yes. Then I think we can open up for questions.

And we have some questions today, too. Congratulations on surpassing NOK 200 million in first quarter revenue. APAC delivered strong growth in this quarter, accounting for around 24% of sales of own products. What is your ambition for this region? And which markets do you see offering the greatest growth potential from today's levels?

Absolutely. So I think the moves we made in Asia Pacific first by establishing our own team in China and going through a little bit of a rough patch in the early days there with some distribution channel issues, we now see that we are really getting a return on that initiative and investment. So it was really encouraging us to move forward also with going direct in Japan.

Then Asia Pacific is, of course, many other interesting countries and opportunities, and we've highlighted India as one of the next big growth opportunities in the territories. And that will also be a region where we will be placing, I guess, more resources and give more attention and continue the great collaboration we have with LivaNova in that territory.

So yes, Asia Pacific is the runners up for driving growth for Medistim. But the Americas and U.S., in particular, will continue to be the major and foremost growth driver also in the sort of near term or the next few years.

Thank you. On the cost side, other operating expenses increased significantly. Do you view this as one-offs? Or should we expect higher operating expenses going forward?

I'll answer that, Kari.

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Well, of the increase of just over NOK 10 million, I would say around NOK 5 million is one-off expenses, and that is related to the IT infrastructure project that will be a project that we will finalize during the year. We also have this agent commission, which are unusual NOK 2.1 million.

In addition to that, I would say that the -- establishing of the Japanese office around NOK 1 million are one-off expenses. But going forward, we will still have that operations ongoing, but this is kind of like a one-off to establish everything. So those are the one-offs.

The recruitment, I mean, Medistim is growing, so we will always recruit. So that will be ongoing. It could be timing related to that when the expenses are coming. And our commercial activities are something that we are actually driving to make sure that our sales force are getting out there and make sure that they have a face time with the customers. So around NOK 5 million, I would say, are one-off expenses.

Thank you. The next one is on currencies. Currency movements have had a noticeable impact on this quarter results. Could you outline your currency strategy and how Medistim manages FX risk?

It's actually very simple. We do not speculate in currency. So that means that most of our cash coming in, in U.S. dollars and euros are then converted to Norwegian kroner as they come into us. However, we do have some hedging contracts that we enter when we do see that the currency is favorable for Medistim. So in that sense, we are a little bit speculative. But in general, it's more like a spot conversion to Norwegian kroner.

This has been the case for Medistim in many, many years. We try to make hedging contracts in order to reduce the risk, but we do see that whether you do that or you enter or convert on spot currencies, all in all, you will -- you could lose or gain regardless. If we do have a secured cash flow for a large project, it makes sense to have a hedging contract because you know then you will have an amount of euros or U.S. dollars coming in.

Our cash flow is not like that. It's more a random cash flow stream that comes into Medistim, and therefore, it's a little bit more difficult to plan that in that sense.

Thank you. The third-party business showed a decline of some 30% compared to 2025. Can you elaborate on the development and the expectation going forward?

Yes, I can perhaps say something about that. I mean, as you know, we had a tremendous year last year. So the first quarter and maybe a bit into second quarter as well, we provided a very strong result and growth for the third-party portfolio last year.

Going back, it has been a lot of variation, but I would say maybe the growth rate has been around 5%, so much more moderate. And I think in sort of a normal circumstance, it's probably around there that expectation should be.

So yes, there's no real changes that we're seeing. I mean we have a solid portfolio of products. We are managing those working closely with the suppliers that we are serving. And we're also seeking new agencies on a regular basis.

So I'm very happy with the third-party team that we have. They are operating a lean organization, providing good margins on their work. Yes. So I'm expecting that to continue sort of in the more historical levels.

The last question is on the public chat. What kind of gross margin level on own products is to be expected going forward?

Well, what we've seen throughout the years is that our own products are increasing more than third-party products. And as we do that, the gross margin increases in percent and also the EBIT margin. So to answer that, I mean, we do have in our reports the split of the segments, sales of our own products and sales of third-party products. And based upon that split, you could see what margins are to be expected from sales of our own product and EBIT margin as well.

The thing though that could affect it is that if we continue to grow, and that is expected in our direct markets, these margins will actually continue to grow as well as we shift more business from direct operation compared to distributor operation.

Thank you. And that was all the questions. Just a sec. [indiscernible]. Could you give us an update on your factory automation project?

Yes. So we have mentioned that one of the projects that we're working on has been to, well, redesign our probes and making them possible to automate. And that part of the project has come to, well, almost a conclusion, and we are in the phase of sort of looking into various options on how to actually move forward with that automation.

So I can't give very specific information about that, but this is a very important and critical project for us. We want to make sure that we have really a future-proof production process that not only provides improved COGS levels for us, but are securing the high volumes that we will be needing to supply the market with when we are fulfilling our growth objectives.

So yes, it's moving forward, and we will give more information when it's becoming more concrete.

Then we are through. Thank you.

Thank you.

Thank you very much, and we look forward to the next encounter. Thank you.

Good morning, everyone, and welcome to Medistim's Fourth Quarter and Preliminary Financial Results for 2025 presentation. My name is Kari Krogstad, and I'm joined with the CFO, Thomas Jakobsen.

And we will go through this usual agenda, starting with the highlights. And I'm very pleased to being able to report a new record for sales in the quarter, reaching NOK 182.3 million in Q4. This means that we are continuing the high growth all through the year that we've seen in the first 3 quarters, ending with 20.6% growth in this fourth quarter. We can see that there is quite a small currency effect when we are comparing to the currency in the same quarter last year. But still adjusting for that, the total sales will be -- could be 21.7%.

And we're seeing that our own products are doing really well, and the sales is up 25%. And it is AMERICAS region that is really leading the way with 44.3% currency-neutral growth. We also see that EMEA, Europe, Middle East and Africa, has a very strong quarter, this fourth quarter being up 24.4%. Our Asia Pacific region is down by 24.2%. And as we have consistently reported all through the year, we have to expect quarter variations from Asia Pacific, but we also expect it to see a solid year, which we will show.

The third-party products has a small 2.2% growth in the quarter, but we know that they had a tremendous start and will finish the year very strong. Also, the operating profit is very strong, NOK 42.3 million, up 63.8% from the same quarter last year. And I just want to mention that the EBIT margin of 23.2%, although being a lot higher than the margin that we reported in the same quarter last year is impacted by an increase in IT infrastructure expenses of NOK 5.8 million. So this obviously had a negative impact. And actually, this EBIT margin would have been about 26% without it. But I will leave to my colleague, Thomas, to give a bit more background for this. But a very decent ending of the year.

This is then taking us to a record year for both sales and operating profit. So almost reaching NOK 700 million in revenues, completing the year at 24.4% growth. Slight currency effect and adjusting for that, the total sales is up 25.8% and we're seeing that our own products sales is as high as 28.3% growth. Again, it is AMERICAS that is leading the way, up 40.5%, but also Asia Pacific, extremely strong at 40% growth and also EMEA with a decent 7% growth for the year. We know that we have a lot of highly penetrated countries in that region.

And also our third-party products having a record year and growing 12.7% in '25. This takes us to an operating profit record at NOK 196.2 million, up almost 50% from last year and also giving us the strong EBIT margins at the high 20s that we would like to see of 28%, and this is very much driven by the strong sales of our own products through the direct sales channel.

So based on these results, the Board will suggest to the general assembly a dividend of NOK 8 per share, a total of NOK 146.2 million. So this means that we are able to adding another record year to our history and also meaning that we continue to deliver on our promise of profitable growth consistently over time.

So with that, I will leave the word to Thomas.

Thank you very much, Kari. I will, as usual, take us through the financials for the quarter, but also for the year. Since Kari is going through sales revenue more in detail for geography and products, I will not go into that detail here, but I need to mention that with record sales and especially sales through our direct markets and especially the U.S.A., this improves our margin going from 77.8% to 80.2%. Having said that, on the negative side, we actually have here a tariff expense of almost NOK 4 million included in the cost of goods sold related to the tariffs implemented in the U.S., which for Norway is 15%.

Salary and social expenses increases as we discussed in previous quarters, we've strengthened our commercial team, but also our R&D team and operations. At the same time, we also have a record year, which means that we have higher commissions and also bonuses related to the results that we are now presenting to you.

Then you would expect maybe on other operating expenses with Kari's note that NOK 5.8 million is expense related to IT infrastructure. And when you compare that to last year, the expense is almost the same. And the reason for that is that we had also a very high expense level in the fourth quarter in 2024 related to congresses and especially the launch of the INTUI software. In addition to that, we also had recruitment expenses to our new commercial sales team. So both fourth quarter 2024 and fourth quarter 2025 is then relatively speaking, high when we look at these quarters.

So what is this IT infrastructure external expense? Well, we do have an ERP system, a CRM system and a PDM system that is today on-premise, which we are lifting to the cloud -- to a cloud solution. And if we were to lift this from one on-premise solution to another on-premise solution, this would obviously be an asset for the company. All the expenses related to that work would be company property and therefore, an asset. When we do this from on-premise to a cloud solution, still the coding that's Medistim related is still an asset. But according to the international accounting rules, when you are using standard configurations and standard setups, that part of the project lifting it to the cloud is not an asset, and therefore, this part of the project is expensed. And what we've seen here for the fourth quarter, NOK 5.8 million has therefore been expensed, and that's the explanation why we have this situation.

Even so, EBITDA increases from 21.4% to 27.1%, ending at NOK 49.3 million. Depreciation is slightly higher than last year. But even so, EBIT percentage increases from 17.1% to 23.2%, ending at NOK 42.3 million. Net finance is currency-based realized and unrealized gains and losses, ending positively for the quarter with NOK 5.5 million. All in all, profit ends at -- before tax ends at NOK 47.8 million and profit after tax increases 78% and ends at NOK 38.1 million for the fourth quarter.

So going into the total year, yes, we almost end the year at NOK 700 million. So this is definitely a record for Medistim. When we look at margins, same explanation as for the quarter. However, the total tariff expense in 2025 is also NOK 4 million, which means that before the tariff was introduced in the U.S., we shipped over all the products that we were able to ship to the U.S. to avoid the tariff on those goods, which means that we've been selling from an inventory in the second and the third quarter of 2025 on products that are not affected by the tariff. So we do now see that in the fourth quarter, we have the full effect of the tariff. And going forward in '26, we will continue to have this effect as long as this tariff of 15% is valid.

Salary and social expenses increases and the explanation is the same as for the quarter, only larger numbers. Other operating expenses also increases, and we have been very much pushing our sales team to be out with face time to the customers. So the increase of the expense is related to our commercial teams being out there traveling, visiting customers, and we have very good experience that the more face time we have with our customers, the better results we will have on sales. So that is something that the new commercial team has been pushing.

EBITDA percentage increases from 27.7% to 31.6% for the year. EBIT margin also improves from 23.3% to 28% and ends at NOK 196.2 million. Net finance, I can also add in addition to currency that we have effect of -- positive effect of interest on additional cash, which amounts to about NOK 5 million. All in all, profit before tax, first time is over NOK 200 million for Medistim and ends at NOK 206.8 million and profit after tax ends at NOK 159.2 million, up over 50% compared to last year. So a record year of top line and bottom line.

Balance sheet, our intangible assets increases. 3 major reasons for this. We have the 2 development projects ongoing, but we also have the IT infrastructure project, taking our systems from on-prem to the cloud, increasing the intangible assets. When it comes to inventory, we see that inventory level is at the same level as last year. However, our inventory level peaked by the end of the second quarter at almost NOK 175 million. And the reason for this was related to the period when supply chain was an issue, and we placed orders, which we now have honored and this has been delivered.

So going forward, from a lot of our critical components and some of our most expensive components, we do not expect to do purchase on these components in 2026. And we will then -- the orders that we're now placing is then for delivery in 2027. This means that going forward in 2026, I would expect to see inventory levels actually decreasing. Accounts receivable increases natural when we increase sales. Our cash position is solid, ends at NOK 212.1 million. And as Kari mentioned, our Board, based upon the solid cash position, a very good year 2025 profit-wise and a good forward-looking situation in '26 and going forward, the Board has suggested to the general meeting to pay a dividend of NOK 8 per share, which is NOK 146.2 million in cash payment in total.

Our equity liability, we have a strong balance sheet, more than 70% equity. Also, our long-term liability is not related to bank debt. So we have no interest-bearing bank debt. And this is then related to extended warranty and service contracts, which is here deferred income, NOK 11.5 million. And we also have a total of NOK 49.3 million in obligations related to our lease contracts, of which NOK 37.5 million is long term.

Some key figures. We see that our earnings per share increases quite nicely in the fourth quarter ends at NOK 2.08. So Krones is the Norwegian termination for NOK. For the year, it ends at NOK 8.71 per share, which is up and corresponding to the development in our profit, obviously. So again, a strong year. Our cash flow is also positive. We have a strong cash flow from operations, both for the quarter and for the year. Our investments, NOK 36 million in total for the year, we have NOK 22 million related to product development. We had NOK 10 million related to our IT project as the 2 major investments that we are involved in at the moment.

Cash from financing ends at NOK 122.7 million, and the majority of that is the dividend we paid in May of NOK 109.5 million. So net -- change in cash is positive with NOK 32.8 million, and we end the year with a cash position of NOK 112.1 million, which is also a record actually going out of the year when it comes to cash. So by that, I leave the word again to Kari to continue this presentation. Thank you.

Yes. So let's take a deeper look into the various products and segments starting with the Flow-and-Imaging systems In units. So we see that we have volume growth in all regions, giving a net 5 more Flow-and-Imaging units sold this quarter. And we are, of course, very happy to see this development both for the quarter, but even more so for the full year. We see strong volume growth in AMERICAS, which is in volume growing by 84% and also in Asia Pacific, up 75%. And as we all know, this is really the most important product from Medistim, it is really what separates us from competition, having these 2 modalities in 1 system, both imaging and flow. And it's the higher value, higher priced products.

So it's very important for us to see increase in sales of this particular product. EMEA, as we can see, is down for the year by 14% but it's growing on the Flow system side. When we are selling more imaging systems, we also expect to see more imaging probe sales. This particular quarter, it is down, but we are noting that the third quarter this year was exceptionally strong, so not really a big surprise. And again, for the full year, with the very strong performance in the AMERICAS of the sales of the imaging products, we also see the strong volume growth on the probe side with a growth 81%.

Asia Pacific and EMEA was done in volume for imaging probes. We're then looking at the Flow-only systems, we are down for the quarter. And -- but for the full year, Flow-only system volume was down in AMERICAS by 36%. Of course, this is related to the high growth that we're seeing on the imaging side in AMERICAS, But we're also seeing that Asia Pacific also growing on imaging is actually growing 35% on the volume side with the Flow-only systems, which is very strong. EMEA also up 6% on the volume side here. So we are seeing after a couple of challenging years that the imaging sales are gaining momentum again. And Flow-only units then rose 4.3% to 121 units, while the combined Flow-and-imaging unit surged at 39% to 92 units. So about 43% of the total number of systems was actually including the imaging in 2025.

Also when it comes to flow probes in units, we've had a great quarter and a great year. So for the quarter, we're growing 26.5% in units. And for the full year, flow probe volume sales is up 20.7%. This is very much driven by the strong 17% growth in capital sales of all systems. And yes, so as a conclusion here, it is both the capital system sales, but also increase in use that is driving the demand for these consumable flow probes.

Looking at the regions in a little bit more detail. So starting with AMERICAS. And as we know, more than 90% of the revenues from this region actually comes from the United States. We are ending Q4 at NOK 86.1 million, meaning 44.3% currency-neutral growth. And we are seeing that total capital system sales declined by 2 units, but we are selling 2 more imaging units, and these are really high-priced products. So it really compensates for the lower number of units.

We also saw strong probe sales for the quarter. Flow probes up 56%, imaging probes up 15%. So extremely good performance in the U.S.A. And also, we are seeing positive contributions from the smaller parts of this region. Our new direct market Canada has shown a very positive performance all through the year and had a growth of 56% in the fourth quarter. Latin America is a very small region here.

Closer look into the AMERICAS. Here, we can see what the impact of selling more capital systems on the Flow-and-Imaging configuration. This is really what drives the revenues from AMERICAS. So 28.6% growth in volume for the quarter, but 84% growth in volume for the full year. Also, when we're counting the number of procedures coming from sales, whether it's from the smart cards and the lease agreements that we have or directly from selling flow probes to the capital customers, we are noting that this is increasing tremendously, 72.6% from the flow probe to capital customers for the quarter and 60% for the year. And this actually ends at over 100,000 procedures, flow procedures in Americas for the full year.

So this is definitely a new record. And when we are then adjusting for some of these probes being sold to Vascular customers, we are now estimating that we have an adoption rate in the U.S., not at 37% as we reported last year, but at 40%. Also, it's interesting to note that procedures from imaging probes to capital customers is growing nicely, ending at 83% growth for the year.

Looking at Asia Pacific. So as I stated, it's a slow quarter. It's down 24%, but up 40% for the full year. So definitely a success and finally being out of the challenging period after the transition into a direct organization in China. China is the biggest region here, sales were down 49% for the quarter, but up 32% for the year, ending at NOK 45.7 million. And we have to remember that actually all countries in Asia Pacific depends on distributors. And still in China, where we have our own employees, and we are, of course, supporting end users as well, we still are relying on distributors and agents, and this will always give variability in the quarterly sales as we have consistently informed.

Sales to Japan were down for the quarter, but is showing a solid year, 71% growth, ending at, I would say, a normalized NOK 20.6 million when we're looking at historical sales. And as we have announced earlier this month, Medistim will now go direct in Japan. I will get back to that in a few minutes. Also, the other countries and other Asia Pacific distributors are actually contributing very positively, 95% growth for the quarter and 38% growth for the year, ending at NOK 25.8 million.

Europe, Middle East and Africa, NOK 56.2 million in sales in Q4. That is currency-neutral growth of 24.4%. So a really strong finish from the EMEA region. It's particularly a strong quarter for the direct markets, which we, of course, like to see. We're talking about Spain, Germany and all the Scandinavian countries, where we see currency-neutral increase of 13.5% for the quarter. Also sales through distributors was up with currency-neutral increase of 34.3% for the quarter, ending at this 7%, which again, I feel is a decent result, but we have ambitions to grow this in the future.

Third-party products, 2.2% for the quarter, 12.7% growth for the year. This is a highly diversified product portfolio. Mentor and their breast implants, Icare and their ophthalmology products and A.M.I with their urology and proctology products are the biggest contributors here. And we remember that it was ophthalmology products sold to new hospitals in Norway that was really driving the high growth that we saw in 2025. And this took the third-party product portfolio to a new record of NOK 101 million.

So this summarizes and shows that it's a really good performance, I would say, from all regions, but I have to highlight the contributions from AMERICAS and the fact that we are growing 35.9% in total from a very high base of NOK 237 million to NOK 322 million in 2025.

Taking a look at the split of Cardiac versus Vascular sales. We're happy to see that we see strong growth in both Cardiac and Vascular products. But we are continuing to see that the Vascular surgery products continue to have higher growth rate than the Cardiac surgery products. And we're also seeing that it's gradually taking a larger share of the total sales of own products. And in '25, we ended at almost 20% of the revenues from own products coming from Vascular. So this is also a positive development.

If we look at the split of Flow-only products versus the Imaging systems and probes, we then see that after this challenging period in '23 and '24, the revenues from imaging products are back with the highest annual growth so far at 47.4%. And now the revenues from sale of Imaging products make up 31% of sales of own products. Also, when we are checking how we're doing with our recurring revenues coming from sales of paper procedure, smart cards and lease revenues and also sales of our probes, we are seeing that '25 is ending at -- just above 70% as a percentage of recurring revenues. So pretty much consistent with what we've seen over the years.

Then allow me to provide some comments also on how we're doing in implementing our strategy, reminding everyone that our vision is actually to place a Medistim system in every operating room all over the world. That's a big task, and we are making progress, but there is still very high growth opportunities here. A couple of years ago, we launched our midterm goal of being reaching NOK 1 billion in sales in a few years. And with the NOK 700 million that we are delivering in 2025, we are well underway of achieving this goal.

And the strategy to actually get there is this combination of converting the high penetrated Flow-only CABG market to Flow-and-Imaging. It is to continue to grow in those markets where we are underway with flow and getting increased adoption of our flow technologies in every market. It's also to be flexible and provide entry-level solutions in price-sensitive markets and absolutely to build a position in Vascular surgery, which I just showed that we are also progressing on.

Expanding direct market coverage is also a very critical part of our strategy. And now on the 2nd of February, we sent out a press release to say that as of 16th of March, Medistim opens a direct sales office based in Tokyo. And I can report that we already have a solid team with experienced leader in place. And our situation in Japan is well known. We have 90% of the approximately 17,000 CABG surgery procedures performed in the market. And as just reported, we ended 2025 with sales to our current distributor there at NOK 20.6 million.

So the growth opportunity is, of course, coming from our experience of getting closer to the end users is really critical to maximize the value from the market. And the first thing that will happen is that we will capture the distributor margin. And then longer term, we will have the opportunity to continue to grow with our Flow product to convert from Flow-only devices to Flow-and-Imaging devices. We have a decent uptake of imaging system, but it's still only maybe around 35%. So there's definitely continued growth opportunity in CABG surgery. And then comes an untapped potential from Vascular procedures as well.

Another part of our growth strategy is to support activities that will grow adoption in underpenetrated markets for Flow. And clinical marketing is critical. So on the 24th of February, we announced that we will sponsor a new trial, SMARTFLOW, which is a randomized clinical trial in CABG surgery. And we're very excited about this study. First of all, it's going to be led by Professor Mario Gaudino, a very prominent surgeon at Weill Cornell Medicine in New York. And this opinion leader is the first author on the consensus paper published in circulation in 2021, where a group of surgeon experts made 10 expert statements, including the very famous transit-time flow measurement should be used in every CABG case. So it was an extremely positive and supportive article in a prominent paper supporting our technology.

At the same time, in the conclusion in this paper, they stated that, of course, it is desirable to perform a large randomized clinical trial to really -- to provide the best evidence for this claim. And that's exactly what they are now seeking to do. This is a quote from Professor Mario Gaudino. He says that most existing studies evaluating TTFM are small, observational and methodologically heterogeneous. Although expert consensus supports its use, the lack of adequately powered randomized evidence remains a barrier to widespread adoption in clinical practice. This is his words. He also says that SMARTFLOW has been designed as the first appropriately powered randomized trial to rigorously evaluate intraoperative graft assessment with TTFM in CABG.

And by generating high-quality randomized data on the impact of TTFM on early graft failure and by providing a platform that can be extended to assess clinical outcomes, the SMARTFLOW program has the potential to inform future guideline recommendations and promote a more consistent evidence-based approach to intraoperative graft assessment. So this is Professor Gaudino's words. The study design of the SMARTFLOW is that it's expertise-based. That means that 1,242 patients that will be enrolled in the study will be randomized to either a surgeon, an expert surgeon, doing flow measurements routinely or to a surgeon who is not doing flow measurements. So this is the concept of an expertise-based trial.

And the graft patency will be assessed with Medistim's MiraQ TTFM. And the imaging modality will also be available, but it's not mandatory to use that in this study. And we're talking about 20 centers in the U.S., in Canada, in Europe and in Asia that will partake in this trial. And the goal is to evaluate whether TTFM reduces the incidence of graft failure within 1 to 3 months post surgery as assessed by coronary CT angiography. So there are plenty of studies that are already providing evidence for this, but this is going to be a higher quality, larger study randomized that will hopefully provide really the next level of evidence for this.

And providing a positive outcome here, the study may be extended to evaluate the impact of TTFM on longer-term clinical outcomes, and that would include myocardial infarction, repeat revascularization, survival and quality of life. When it comes to Medistim's enrollment here, of course, it's completely scientifically independent trials. We have nothing to do with the interpretation of results or anything. And the study is primarily supported by philanthropic donations and federal funding, but Medistim is then serving as the only industry sponsor, and we will contribute with, I would say, a pretty modest USD 500,000 over the duration of the trial.

This will, of course, be a great opportunity for us to facilitate upgrades to imaging in those centers that haven't already started using imaging, and it's a great way of also getting our newest INTUI software into the hands of these very good centers. We are also facilitating the study with our Case Cloud solution for data collection storage and analysis, the same as we're doing in the PATENT study. So with a good, I would say, great probably '25 behind us and also already moving into '26 with opening up a new market for us in Japan and also sponsoring and participating in this exciting new trial to support our CABG surgery market. We are moving into 2026 as one team, making bolder moves with excellence accelerated.

So with that, I think we will open for questions.

Yes. And we have a number of questions today. The first one is on Japan. Congratulations on the opening of an office in Tokyo. How do you see the growth opportunities in Japan? And will you focus on developing the vascular market there?

Yes, I can comment on that. So first of all, I think we will -- our ambition is to run a more efficient operation in Japan with our own people on the ground. And as I explained, we still have growth opportunities in CABG surgery, first and foremost, from converting from the Flow-only system to Flow and Imaging. But certainly, vascular surgery is also adding growth opportunities. And I might add that the leader of -- the General Manager of our Japanese office actually is coming from a company, a medical device company serving the vascular surgery community. So he is well connected to vascular surgeons in Japan and will really be a great champion for us in our endeavor there.

It's another one on Japan. When you went direct in China, we saw a longer period of low sales and negative margin impact. Should we expect a similar situation in Japan?

Well, we had some learning from our Chinese experience. And one of the learnings was that we have shortened the transition period from 12 months to 3 months. And with the 12 months transition period in China, the distributor had the opportunity to fulfill their pipeline to a much larger extent because of having 9 additional months to fulfill that. So with shortening this period with 2 to 3 months, we have seen actually a limited possibility for our Japanese distributor to do the same thing as our Chinese distributor did.

And also, we have -- although we honor those orders that come in that is tender related that our distributor has worked through, we have also been very restrict on typically larger probe orders if that were to come in. Having said that, we haven't seen that as of yet. So we are actually quite optimistic that this Japanese transition will be much smoother than the Chinese one. And also, in addition to that, our position in Japan, where we have 19% coverage at least on CABG. We have a very strong recoverable revenue stream. And we do believe that in the first year of '26, we will at least have an EBIT margin or breakeven situation in Japan maybe even a slight positive contribution. But at least going forward into 2027, we are convinced that Japan will give us a positive contribution to our profits.

The next one is on the tariffs. The report indicates that price increases have been absorbing the tariffs in the U.S. How has the price increases been received in the market? And do you think the price increases can affect sales volumes going forward?

I take that too, Kari. Well, I don't think any customer will embrace a price increase as such. But having said that, we haven't seen any significant resistance in the U.S. related to the price increase either on systems or on probes, and we do see that capital sales are continuing to grow and also probe sales. And we introduced this price increase effectively end of June. And what we've seen at least on probe volumes is that flow probes in the second half compared to the first half increased with 38% in volume.

And the same for imaging probe, which has increased 50% in volume. So, so far, we have not experienced that this price increase is actually decreasing volumes. It's rather the opposite. So going forward, we are quite optimistic that this price has been accepted.

We have more questions on tariffs. Does the NOK 4 million hit due to the tariffs imply that all the products sold in the U.S. in the fourth quarter were tariffed? Or will this number continue to increase as more and more stock run out that was not tariffed?

Fourth quarter, all products were tariffed. So that is the level that given the same sales volume in the U.S. going forward. So this actually started the last days in September actually in the third quarter. So fourth quarter is a full quarter of -- with full effect of tariffs.

Yes. And it's a follow-up on that. How high do you expect the annualized run rate for tariff expenses in the U.S. to be once all inventory is sold?

This is more or less answered and this is all dependent upon the level of sales in 2026. We do have a tariff of 15% -- 50% sorry -- 15%, sorry, 1-5. And the effect of that for us when we import to the U.S. is that we will have to increase our external pricing with 9% in order to neutralize it. And as we've seen from our report today, we more than neutralize it by actually increasing our gross margin. But to say how much tariff we would pay would kind of for me today, be impossible to say an exact number.

The next one is on the number of procedures. How come there is such huge jump in the procedures in the U.S.? Have there been higher demand for probes due to the announced price increases?

No, I would say that the increase in capital sales and the way that we are approaching it is also always selling sort of a start-up package with probes. And I think that has also probably grown with the new approach from the new sales team. So it's really connected to getting new users started with the Flow technology. Of course, some of this is then, you could say, for inventory, it will take some time for these new customers to consume all of these probes, but -- and that's what we're trying also to estimate when we're saying that adoption rate has grown. But with the large increase that we're seeing, part of this is definitely due to increased utilization.

Then we have some questions from the chat. Could you comment on development in larger EU economies and whether you have plans to go direct in new markets there?

Yes. Europe is still very interesting for us. We have pointed to Turkey as actually a new target market for the EMEA region. And Turkey actually have a higher CABG number of procedures, for instance, than Germany as, of course, the largest European country as such. So that's the progress we made in 2025, working with our distributors to refine our business strategy and model there. So that's definitely a new market that we will invest more deliberately in and provide more support to in '26 and onwards.

Then we also have interesting, I mean, markets that's been worked by our distributors for a long time, we talked about Italy and France, which are currently at around 40% adoption of Flow technology. So obviously, a lot to do there, both to increase the use of Flow, but then also to convert to imaging and of course, the Vascular also to follow. So -- and in general, I can just give the answer that we have a list of countries which are of interest when it comes to being targets for the next go direct strategy.

Congratulations on the strong year. Regarding the U.S., what has been the main trigger for the strong growth acceleration there? Is it insurance policy changes or industry becoming more aware of the value proposition? And do you expect penetration to keep rising at a similar pace this year?

I think the fantastic results we're seeing from AMERICAS this year is a result of numerous factors. First of all, '23, '24 was more challenging on getting the capital sales of imaging systems as we pointed to. And really selling imaging, high value, high priced is very important for continued high growth. So getting back into that situation where actually the interest in our imaging technology is actually successfully converted into a sale that has happened in 2025. And that is, of course, due to our long commitment to positioning the imaging technology, and we're seeing the results of that. We never lost confidence that the surgeons wanted the imaging technology, but it was the economical situation in '23 and '24 that was postponing a lot of the sales processes. So that's one factor.

But then I think the change with a strengthened commercial leadership and also intensive and significant investments in supporting our sales force in the U.S., but also in all our direct markets. We've done a lot when it comes to improving our training for our sales reps this year. We provided numerous events for training, both on the technical, clinical and definitely on the sales side of the sales process. So I think that also contributes very well. And of course, the attitude, the strategy from sales leadership, which is, I would say, more forward-leaning, more ambitious and definitely showing very much a can-do attitude. So I think it's multiple things.

Of course, pricing, we have increased prices as well. That's also contributing. But as we have shown, this is combined with the increasing volumes as well. When it comes to whether this will continue, I think it will be very hard to keep it at the current or the '25 growth levels going forward. As I said, a lot of this is coming from the comeback of the imaging systems and probes, which were really low in '23 and '24. So that growth level will not be there in 2026. But the investments we made in the team and also increasing the confidence and going after the vascular opportunities will continue to provide opportunities and support further growth in the U.S.

The next question is on INTUI. INTUI has been mentioned in your previous presentations, how much of the growth last year was done to this new launch?

Yes, actually very little. We have to remember that we started selling the INTUI in the second half. And that means that we are then starting to introduce the INTUI into the sales -- the new sales processes. When it comes to quotes that were already out there based on the former configuration and former pricing, that was for the large part, just kept as it is. So I think we had a total of 8 INTUI sales in the second half.

And then we also have to remember that for now, we are selling the INTUI for the cardiac-only systems. We're not making it available yet for the Ultimate systems and the Vascular systems. The Ultimate is the combined solution for both Cardiac and Vascular. So this really means that when we're going forward, more and more of our sales will be on the INTUI. That means that the upside from the INTUI launch is still ahead of us, which I think is a great thing.

You announced your support to the SMARTFLOW randomized clinical trial on TTFM reducing graft failure led by Prof Gaudino recently. Do you think this will affect Medistim sales going forward?

As I said, we're very excited about this study. I think it's that lacking piece of evidence that everybody has been talking about and found it very difficult to address because it will be costly to do a large trial like this. And also there are ethical aspects that we never got flow users, surgeons that are using flow to accept not to do the flow measurements on some of their patients. That's why they come up with this expertise-based randomization strategy. But I would again also point to the fact that we have achieved a very high adoption rate in many countries. I mean, 90% in Japan, 80% in Central Europe and Nordics and well underway in the U.S. with 40% right now.

So I -- there's no reason to wait for the trial and think that we will not be able to grow. We will grow year-by-year without the data from this trial and also without the guidelines that can come out of it, which is, of course, many years ahead. So -- but I think the value of it is really to keep attention to flow technology and really the question of the value of using this technology versus not using it. So I think it will keep the topic relevant and interesting. It will be talked about in the conferences for the years to come, which is all positive for Medistim and for the sales of our product. So I do think it will be supportive. I don't think that we are depending on it.

Thank you. That was all the questions this time.

Thank you.

Then we say thank you for this time, and we will see each other for the first quarter report. Thank you.

Good morning, everyone, and welcome to the presentation of Medistim's third quarter results. So my name is Kari Krogstad, and I have my CFO, Thomas Jakobsen, with me, and we will take you through the results.

Before entering into the highlights, I would like to remind ourselves on our track record and our commitment to deliver profitable growth consistently over time. And as these graphs are describing, that is a promise we have delivered on.

So let's look into the highlights for the third quarter. And after a record start of the year with the first half providing records both for sales and revenues, I'm very happy to present our best third quarter ever for both sales and revenues or operating profits. We can see that we are delivering NOK 166.8 million in revenues. That's a 25.7% growth. And EBIT also growing very nicely, ending at NOK 40.6 million, 27.1% growth. We can see that we have very little currency effect this quarter. That means that the total sales is almost the same, 25.9%.

And looking at the sales of our own products, we see that, that is at almost 30%. So a very, very nice contribution from our own products this quarter. And Americas is continuing to take the lead here, up 35.7%. And of the NOK 34 million of growth this quarter, Americas are actually delivering NOK 21.5 million. So 63% of the total nominal value here is coming from Americas, just highlighting the importance of this region for Medistim's growth. Asia Pacific also delivering very nicely, 194% growth. And the only disappointment here this quarter is that EMEA is a bit down. It is the European part that is showing a decline this quarter, while the Middle East, Africa section of it is actually growing, and we will get back to more details into what's happening this quarter in EMEA.

The third-party products has a normal growth, we would say, looking back at historical levels that has been around 5%, so 4.4% is in line with that. We can remember that we had a fantastic first quarter due to some new hospitals establishing their practices here in Norway. So this is really getting back to a more normal situation.

This strong sales performance has led to some higher commissions and accruals for year-end bonuses, and we will see that the operating expenses has increased also quite a lot this quarter. Still, the operating profit is up by 27% and at a margin of 24.3%, so pretty decent.

Looking then at the year-to-date situation. So that means that we are still at the best level yet, record sales revenues and EBIT year-to-date, NOK 517.5 million, 25.8% growth on revenues, ending up at NOK 153.9 million in EBIT, a 46.2% increase. Again, very little currency effect here. So total sales up 26%. Our own products, very high, 28% growth. And Americas, as indicated, really taking the lead here in the growth year-to-date at 36.2%. Asia Pacific also contributing very nicely, 73%. And year-to-date, EMEA is up at 1%. Third party, well, this is an effect of the tremendous first quarter we had. So year-to-date, this is growing at 16.2%. And operating profit up 46%, a strong EBIT margin at almost 30%, and this is related to strong sales of our own products.

So with those highlights, I will leave the floor to Thomas to go through the P&L and some of the other numbers, and I'll return with some more details on the business segments.

Thank you for that, Kari, and good morning, everyone. I will take us through the P&L, our balance sheet and cash flow for this quarter and year-to-date. And since Kari is going through sales figures in units split of sales per product and geography, I will not go into that detail in my presentation here. However, cost of goods sold and gross margin is increasing with 1.2%. That despite the fact that we have a strong increase in sales of our imaging portfolio. As we've said before, our Imaging portfolio has a slightly lower margin than our flow products, but we have very high pricing on the imaging products, and it's very profitable for Medistim. And this is partly compensated with high sales to our direct organizations, especially in the U.S. And therefore, we have an improved gross margin of 1.2%, ending at 81.5%.

Salary and social expenses increases from NOK 46 million to NOK 60 million. Yes, we have increased our capacity in our commercial organization and elsewhere in the organization. But the main driver for this increase is actually related to incentives and commissions and bonuses. In the third quarter last year, we did realize that our internal goals would not be achieved. So we had actually a reversal of the accrual that we made in the first half of last year in the third quarter. So practically 0 commission and bonuses was recorded in the third quarter last year. This is obviously not the case in this quarter and so far this year, and this is the main explanation for why our salary and social expenses increases the way it's -- that we can see here.

Other operating expenses is also increasing and, again, related to our commercial activities. We have much more travel expenses and face time with customers through our sales force and marketing departments and so forth. Therefore, we have increased other operating expenses as well, as a consequence.

Our EBITDA increases NOK 8.7 million, ending at NOK 46.4 million. Depreciation increases. It consists of both lease obligations, but also depreciation on development products and other fixed assets. And our operating profit increases 27%, ends at NOK 40.6 million. Net finance is very positive this quarter related to currency, but also hedging contracts and a net positive contribution of NOK 5.4 million. Profit before tax then is about NOK 15 million higher than last year, ends at NOK 45.9 million. And profit after tax ends at NOK 34.7 million, up 48% compared to last year. So strong growth in profit this quarter.

If you look at the year-to-date numbers, the explanations are the same very much as for the quarter, only bigger numbers. And still, the increase that we see here on salary and social expenses is also actually with the same explanation as for the quarter, where we had very low accruals and commissions in 2024, where we did not reach our internal goals, again, this is not the case in 2025. And we've also seen that the incentives that we set for this year has actually given us great results in many of our regions, especially Americas and also in the APAC region as such.

EBITDA increases around NOK 48 million, ends at NOK 171.7 million. Depreciation being at the same level, our operating profit ends at NOK 153.8 million. That's up 46%. And if you look at the top line, we increased with more than 25%. And our expenses increases only 20%. This gives the very positive impact on our EBIT and profit as such. Net finance is also positive year-to-date, ends at NOK 5.1 million, again, currency related. Profit after tax ends at NOK 159 million. Profit after tax, NOK 121.1 million, up 47% compared to last year. So a strong year-to-date so far for Medistim.

Our balance sheet, intangible assets increases. We have our 2 major development projects that we are investing in. Fixed assets decreases. That means we depreciate more than we have invested so far this year. Inventory ends at NOK 167 million. That's up from the beginning of the year. However, it's actually down from end of Q2, which ended at NOK 174 million. So we have now seen a decline in inventory, based upon what also was communicated with those orders that we have committed to that are now fulfilled from our end. Accounts receivable is increasing, ends at [ around NOK 73 million ]. And we have a strong cash position now recovering after our dividend payment of NOK 110 million in the second quarter, and we are now well above last year's position, NOK 127 million. In this quarter, we're at NOK 157.7 million. So strong and good cash position.

Further on our balance sheet, we have a strong balance sheet with equity of almost 73%. No interest-bearing debt is from bank or other credit institutions. So our long-term debt is related to lease obligations and extended warranty. The long-term liability related to this is NOK 28.6 million. Total obligation is NOK 37.9 million.

Yes, some key figures. When we have strong profit, obviously, our earnings per share is following, and we have already NOK 1 per share more at the end of September compared to the whole fiscal year 2024. So good performance so far.

Our cash flow, strong cash flow from operations year-to-date, but also very strong cash flow from operation this quarter. And apart from good profit, we also had a reduction in the working capital, decreasing both inventory levels but also accounts receivable, and gives us a solid cash from operation of NOK 69 million. Investments, NOK 6 million, mainly related to our development projects, as I mentioned earlier. And net cash from financing is basically our lease obligation. So net change in cash this period is NOK 61 million, which is drastically up from last year's third quarter, which was only NOK 20. 3 million in comparison. So again, we end the period with a good and solid cash position, ending at NOK 157.7 million.

And with that, I leave the word again to Kari. Thank you.

Yes. Let's take a look into the details here. So starting with the unit sales of Flow-and-Imaging systems in units. So we see here that we have a net positive number of 9 more systems sold this quarter compared to the same quarter last year. And it's really Asia Pacific that is driving this. We see that they are up by 8 units. Americas is up by 2 units. America -- or EMEA is down by 1, and we will see that EMEA is actually down on all of the different product categories this quarter as a number of units.

I think it's interesting to note that this quarter, we are actually selling around 50% of the total number of systems sold for Medistim is with the imaging inside. And this is a very nice and positive development. I think historically, we have been around 40% of systems being on the -- with the imaging components integrated. So this is definitely a development that we like to see. Also very good this quarter, imaging probe sales in units is growing as high as 73%. And it is Americas that is driving this unit sales, 27 imaging probes sold this quarter, which is extraordinary. Asia Pacific also doing well here. EMEA down by 10 units.

Looking at the Flow-only systems in units. We are up 5 units in total. Asia Pacific, up by 9. And both Americas and EMEA is slightly down in number of units here. Flow probes also have a very strong performance this quarter, 22% growth in number of units. And again, Americas is really driving this growth, 66% growth in number of flow probes sold in the Americas. And of course, Americas is U.S. for the most part, although Canada and South America is also contributing. Asia Pacific, up 59%. EMEA, down 10%.

So let's take a closer look into the Americas. So we are delivering NOK 83.2 million in sales in the third quarter; currency neutral, 35.7% growth. We see that the number of systems sold is really on the same level as last year, but we're selling more imaging units. So that is, of course, contributing to the higher revenues. Also mentioned strong probe sales for the quarter, both from the flow probes and the imaging probes. Canada also continuing to contribute, growing this quarter with 68%. And also Latin America is growing -- or a little bit lower actually, but it's very small numbers. So it doesn't really have a big impact.

Looking at the number of procedures that's coming out of the U.S.A. I've already commented on the number of systems. So that's the first table here. But look at the number of procedures. Here, we can see really the impact of the many flow probes that were sold this quarter. So that translates into an extremely high number of procedures. And also, when we have this very high number of imaging probe sales, that, of course, also translates into a very high number of imaging procedures. This is not to say that this is a measure of the utilization of the systems for the same period. I have to be very clear about that. But certainly, it's a nice development. And if we look then at the number of Flow-only procedures sold in the U.S.A. per year, and we're looking at the year-to-date numbers here, we see that we are covering or supporting around 37% of the CABG procedures in the U.S. with our technology so far, so steadily improving.

When it comes to Asia Pacific, ending up at NOK 25.2 million in sales, 194% growth. And the most important thing to note here is really that we are seeing a continued normalization in the sales to China. So this was our promise at the beginning of this year that we expect to see quarterly variations, but a normalized year. So in the third quarter then, we saw that the sales was up 143% in China specifically. Also contributing to the great results in Asia Pacific for the quarter is Japan, contributing with NOK 6.7 million, but we had 0 sales from Japan in this quarter last year. And also, other distributors are contributing.

So EMEA: EMEA is -- as you see, EBITDA (sic) [ sales ], NOK 37.1 million, down by 11.8%, currency neutral. And this quarter, it is actually our normally highly performing markets, the direct markets, Spain, Germany, also Scandinavia, which is showing a decline for the quarter, 26.8%, while the distributor portion of the business is having a good quarter with 22.3% growth. So I think that we have to keep in mind that both Spain, Germany and Scandinavia as well are markets where we have a very high penetration in the CABG part of the business. So with the flow technology, it's really almost fully penetrated. So the growth needs to come from conversion to imaging, which is steadily ongoing, but still that will continue to take some time. And for the future, we really rely on building and developing the market for our vascular products. And of course, there will be some new target markets. We're currently working our way into the Turkish market. That will also contribute to the future growth here.

The third-party products, as mentioned, started on an extremely high note, revenue up 4.4% for the quarter. And then, with this first quarter strength, we are looking at a year-to-date growth of 16.2%. So all in all, a very, very strong performance from the third party.

So this leads to the regional performance as we see in this table. U.S., up 32%; Canada, up 68%; South America, up 251%. China, as we see, 143% up. The rest of Asia Pacific, up 84%. And then, Europe, especially the European direct markets this quarter, down 17.9%. Middle East, Africa, up 133%, of course, from a much lower number. And this leads to the total sales growth of 25.7%.

When we look into the split of Vascular and Cardiac, we see that we are having an unusually slow development for the Vascular products this quarter. It's growing only by 3.7%. Then, I will ask everyone to keep in mind that both Q1 and Q2 actually delivered more than 40% growth. So this is leading to the year-to-date situation where we're growing at 29%. And looking a little bit back into our history, the growth in Vascular has probably been around 20%. So we are still delivering very good developments in Vascular, and some quarterly variations always have to be expected. Also, I would like to point to the fact that the Cardiac product portfolio is also developing extremely nicely, almost 37% growth for the quarter and 27% growth year-to-date.

And we are always interested in seeing the imaging development. And this year, we are seeing terrific performance here. So almost 40% growth for the quarter and 52% growth year-to-date, meaning that the interest in our imaging products is as solid as ever. And this business is really coming back after weaker 2023 and '24.

When it comes to the recurring revenues, this is when we are counting sales from capital probes, PPP smart cards and lease revenues, continues to be high. It's for the quarter, 72%. And for the last 12 months, we are at 69%, so also very solid.

So it's typically a business as usual quarter for us. No big news to talk about. However, I would like to just reiterate how we started the year, and I know I've been talking about this every quarter. But in the beginning of the year, we knew that we were standing at, as we said, a pivotal moment for the company. We were just about to launch the INTUI software platform, and we were also starting the patent study. So we felt it was a perfect time to strengthen our commercial efforts. And I've talked about the organizational changes that we've made and also some of the operations that we have changed in that part.

I also would like to say that something we have invested quite a lot of time and resources on this year is to establish or reestablish the Medistim Academy. We have actually revamped our training and education program for the sales force. This is part of the efforts of really strengthening our commercial operations at large and really supporting our sales reps and enable them to do the best possible job out in the field. So this is a new program with theoretical and practical exams. It will lead to a certification for the individual sales reps. And the content is, of course, both on product, on clinical application knowledge and also on the selling skills. So we have developed our own sort of model for how we want sales to be performed by representing our products in the best possible way.

So with this, I will leave you with the theme for the year, one team, bold moves, excellence redefined. And we should open up for questions.

Yes. And as usual, we have quite a few questions, and the first one is quite general. Congratulations on another strong quarter. Americas is driving the growth, while relative growth is even higher in APAC. EMEA, on the other hand, seems softer. Going forward, where do you expect growth to come from?

Yes. So I mentioned that today, Americas is actually contributing with 57% of the total sales of our own products. And I think it's with the investments that we are making in the U.S. in terms of building out the sales force and really continuing to build on the momentum that we're seeing there. There's every reason to believe that the U.S. and Americas will be the growth driver also in the near term, in the near years to come. And this is driven both by increasing key opinion leader support, more awareness steadily increasing, strengthening the sales force, as I mentioned. We really have a lot of things going for us in the U.S. So that will be the most important growth driver also going forward.

But Asia Pacific is really the medium to longer-term growth engine for us. And you should remember that we have the highest growth market in the world in China and in India, growing in number of procedures -- CABG procedures more than 10%. So of course, that's the motivation for developing our own direct sales organization in China and also for our heavy involvement and collaboration with LivaNova for India. So I think that will be the next one.

And when it comes to Europe and Middle East, as I said, it is a much higher penetrated market for coronary bypass surgery, CABG, but we still have growth opportunities in Vascular. So for us to grow in EMEA, it will be to increase our efforts on the Vascular side, add some additional markets, of course, also go direct when the time is right.

The next one is on the U.S. You are presenting significant growth in procedures in the U.S., both for TTFM and imaging. Is this due to orders being placed prior to price increases? Or is this down to other market factor? And is the price increase both for TTFM and imaging products?

Yes. We did a general price increase as of the third quarter. And of course, we've been very curious to see whether that would impact the volumes. What we can see that the high volumes of probes sold in this quarter was at the new pricing. So that's at least an early reassurance that we are -- yes, that the new pricing is accepted. But of course, we will need to see that also a little bit further into Q4 and see what the achieved selling price really will be. But so far, yes, it was not a stocking up before a price increase.

Thank you. Vascular shows slower growth this quarter, around 4%. What do you expect from this segment going forward?

Yes. So I think in our quarterly variations, we see it all the time. It can happen in regions. It happens to the different products. That will always be the case. And all in all, we see a very solid development from the Vascular. But the reason why we believe that Vascular can be trusted to be a significant growth driver for the company going forward, that's really the response that we're seeing now that we are making more deliberate efforts in creating this interest awareness through the patent study and building all of these centers that are participating. For now, we have about 55% enrolled in the study. We are still getting the last study sort of up and ready for starting to enroll.

So this is a slow process, but it's moving forward. And we feel there's enthusiasm in this group of investigators, and they are already talking about the technology. And as we know, it's an extremely influential group. So with that investment and everything that we do also on the sales side, I should mention that on the training and education program that I just talked about, we have focused on peripheral bypass as the #1 application area where we really wanted to lift the sales force and support them in how to engage with vascular surgeons. So we are determined to support, invest in the area. We're seeing that we are getting a response from the market. So that will be very positive, I think, going forward.

Thank you. And there's a question on cost. Your cost base is growing. Can you elaborate on the increase? And how flexible are you if you experience lower sales for some time?

Do you want to...

I can answer that question probably. Well, I was touching upon the topic in my presentation. And what we -- when we look at our increase in salary and social expenses, it can look like we have hired a lot of new employees. Yes, we have hired some, but the main driver for the growth is actually related to incentives and internal goals that we've been setting. So obviously, when these costs are then increasing, this is related to the fact that our internal goals have actually been reached. For instance -- and the main driver for this is U.S. And what we have done for this year is actually to lower the fixed part of compensation and increase the variable one. And if they reach their targets, then they will receive a good commission or they [ reach ] their incentive. And we've seen that throughout this year. And also, as a consequence, we have seen a good growth on our top line.

If they would not reach their targets, the consequence, for instance, for the third quarter would be a reduction in expenses of around NOK 10 million, and for the first 9 months, more than NOK 20 million. So that means that we, in that sense, have actually a quite flexible model when it comes to goal setting and reaching our targets. So when targets are reached, yes, then the expense will increase. But if it's not reached, then there will also be a reduction in expenses.

Thank you. There's a question on Turkey. You mentioned Turkey as a new market. Will you start this market with the distributor? Or will you go direct from the start?

Yes. No, we will follow our traditional method of always starting with a distributor in order to understand the market, map the market and also see whether that's resonating with the users in that market. And then, we also want to have a certain level of business before we even starting to consider to go direct. So definitely, we have started with a distributor. So our job now will be to really support that distributor and follow up closely and ensure that we have selected the right one and that we're seeing the development and results that we need to see. So that's for the future to evaluate a direct operation there.

Thank you. There is a question, a wide one. Can you comment on France, Brazil, Japan and India? Are there any plans of going direct in these countries?

France is pretty -- well, it's a challenging country for us. I believe our penetration today is probably around, I don't know, 30%, a little bit more maybe, but still not in the highest end in Europe, definitely. It's one of the countries that it's reasonable to look at for a direct operation. So you could say that's on the list.

Japan is -- yes, it's been -- we have had a great development with our distributors for, I would say, 20 years or more. So they have done a tremendous job for us in developing the cardiac market for flow. They have also done a good job in developing and the conversion to imaging in the market. But as we've seen over the past several quarters, there's been some reasons for concern, and the total business have been challenged and we haven't seen the steady development that we used to. And of course, this is a profitable business. It is also one of the countries that we should think about for going direct.

And then, you mentioned Brazil. Brazil -- well, South America in total is -- hasn't been really the highest priority part of the market for us. Brazil is the most interesting country in South America. And we do have some business there. We do have some installed base there. And we know that there is interest from Brazilian surgeons definitely for the products. So it's a part -- it's a geography where we are considering to increase our efforts, absolutely not going direct in any near future.

Did you mention India?

India, well, again, we are in a starting phase. I would say, we have 2%, 3% coverage of the procedures performed. As I said, it's growing more than 10%. It will soon actually be larger than U.S.A. and then take the lead as the biggest market in the world in isolation. So definitely a place to be, a place to focus on, a place to ensure that we are present and supporting the local distributor. We are very happy with LivaNova. But we need to work it a little bit further before it becomes even a question to go direct.

Thank you. There's another one from the web. Can you comment on the performance of the direct Europe markets? Why was it down so much after being so strong in the past?

So again, quarter-by-quarter, we do see a lot of variation. And there can be customer projects that are being closed or not being closed entering into the next quarter and so on and so forth. That's something that we've seen historically and we'll continue to see. But -- and that is, of course, if you're not winning the customer or closing the opportunities in the quarter, that will affect everything, like we saw it was down on both system sales and probe sales. So this is, of course, part of the same issue.

I think that we -- of course, our ambition is to continue to grow and especially in the direct markets. We have different challenges. Germany as one market, very, very highly penetrated, rather price sensitive, not easy to just compensate by increasing price. In Spain, we've seen some resistance to buying capital, and we then introduced more consumables-based deals, which will then result in less revenue at the time of sales, but really then securing the future growth from the Spanish market. So Spain is in really good condition and Germany for that matter. When it comes to U.K., well, it's the occasional close of sale, still haven't really cracked the nut in the U.K., as we talked about many times.

Yes. Then it's a question on Medistim Academy. Could you comment on the Medistim Academy? Is this for internal sales reps only or also for distributor partners?

Yes.

Should I do the [ answer ]? It's a 3-part question. Why did you see the need of reestablishing this? Any particular event? And how would you like your sales force to sell the product? And what does an ideal sales process look like?

Great question. Big question. Well, first of all, of course, we have trained the sales force in the past as well. It's just that now we have revamped the content that we are -- the training materials and approach. We are using a combination of face -- let's say, classroom situations and digital solutions as well in order to do the training. So it's really to elevate the quality of the training.

And talking about how we want to sell, so we have defined and for a long time, defined the Medistim sales process. And we have a very clear understanding of what we need to do prior to the sales and also during the sales process and when we had closed the sales, and how important it is for us to really be present and ensure that our technology is being used, it is being used correctly, it creates enthusiasm and that we are upselling within the customer that we have just sort of won. So it's too long to go into detail about the sales process here. But for sure, we are rolling this out also to the distributors. And even more, we have a goal to establish a similar certification system for customers. But customers -- some of our customers have actually asked for, is there a way that we could certify our team in the hospital in order to make sure that we have some certified nurses and technicians that can really provide the internal training at the hospitals, which we think is a great idea, and that's on our sort of our next to-do list to build out the Medistim Academy.

We have one more -- yes, there's one more from the web here. Americas recurring revenue was strong in the quarter, around 43% year-over-year, but not quite as strong as I might have thought, given the price increases and very strong unit growth of probes. Could you please explain why?

Well, I don't know what the expectation really was, but we feel that the number of units sold was extremely high. And as I say, we managed to sell this high volume of units at the higher price. So yes, I think that's -- I don't know whether you would...

I think I'd maybe add something to that because, yes, the probes sales in units and the pricing we achieved there is obviously within the new pricing. But having said that, we do also have a lot of lease and PPP contracts, which are lasting over a period of time. So the price increase that we implemented from the 1st of July would not affect those accounts. So therefore, a good portion of the number of procedures that we have been -- sold in the third quarter is based upon the old pricing when it comes to the PPP customers and the hybrid customers. So that probably explains why the increase in revenue is slightly lower than one could have expected. Having said that, I'm not sure what the expectation was here, but this is partly explanation.

Thank you. Another one coming in here on incentive structure. Could you elaborate on the new incentive structure and the flexibility that Thomas hinted? Our goal is always set in a way that incentivizes for year-over-year growth. What would happen if bonuses -- to bonuses if growth year-over-year was not to happen?

As I said, it is -- we were setting new targets every year. And of course, if those targets are not reached, then the incentives will not kick in. So again, going into the detail of the incentive plans for U.S. will take too long time. But again, the main principle has been to lower the fixed compensation and then to give the carrot to sort of make sure that you perform because when you perform -- and performance is either -- both increase the existing recurring revenue on one side, and on the other side, actually drive capital sales. So those 2 are the main factors that will drive the incentive for the sales force.

So with that, we say thank you for being with us for this presentation and look forward to meeting again for the fourth quarter presentation. Thank you.

Good morning, everyone, and welcome to the Second Quarter and First Half 2025 Financial Results Presentations from Medistim. My name is Kari Krogstad, and as usual, I'm joined by my good colleague, CFO, Thomas Jakobsen. And together, we will take you through the results.

And just before we dive into the highlights, we like to start by reminding everyone our track record. This is a great reminder of our goal and ambition, which has been and still is to deliver profitable and growth consistently over time. So we can see quarter variations, but our track record shows that we have succeeded to deliver on this promise over the years.

But now let's look at the second quarter and the second quarter highlights. So I'm very happy and proud to being able to present the second best quarter both for sales and EBIT, and it's actually only beaten by the first quarter this year. So we're seeing revenue performance at NOK 169.1 million, which is 16.7% growth over the same quarter last year. And as this slide shows, there is only a slight currency effect here. So if you look at the currency-neutral sales development, the total sales is up 15.7%.

And as always, we are extremely satisfied to see that it's our own products that are providing and really delivering this great growth. So own product sales, currency neutral, is up 18.2%.

Looking closer at the regions, AMERICAS, as we can see, very, very strong performance this quarter, 32.9% currency-neutral growth. And AMERICAS are actually accounting for more than 80% of the total nominal revenue increase for this quarter. So that speaks to the importance of this region.

Asia Pacific also providing great growth this quarter, up 22.9%. And here is definitely China, which is back on track and really driving this growth. But interestingly, we're also seeing some good developments in India, which is a very interesting long-term market for us. We will revert to that.

EMEA this quarter is down by 3.6%, although the direct markets in these regions are performing very good.

Third party, up 3.3% after a very, very strong first quarter.

And when we look closer into the cost side of things, we will see that we have a 20% increase in salary and social expenses for the quarter. This is related to the investments that we're making in the commercial organization, both in terms of head count and also, of course, increased commission payouts in relation to the high revenue.

Still, we are delivering an operating profit of NOK 54.1 million, growing 31% over the same quarter last year and also then helping us achieve a very strong EBIT margin at 32% this quarter. This is, of course, also very much driven by the product mix. A lot of growth from our own products is securing this high margin.

In the second quarter, we also made the dividend payout of NOK 6 per share, a total of NOK 109.6 million.

So great quarter. That makes the first half of 2025 the best first half we have ever delivered. So in the first half, we are seeing NOK 350.6 million in revenue, that is 25.8% growth. We see again very slim currency effect here. So adjusting for this currency, the total sales is up 24.7%.

Own products, performing great, 25.4% in total. And we see that AMERICAS again is really the strongest growth driver here, up 33.7%.

But also Asia Pacific, driven by China. Finally, we're getting out of this transition period with the field inventories in the local distributors in China. So getting out of that, we're seeing that the growth is returning.

EMEA, as I mentioned, a little bit down for the quarter, but for the first half, we are up by 7.1%.

And also when it comes to the third party, we saw a very modest growth of 3% for the second quarter, but we had a tremendous 41% growth in the first quarter. So that means that halfway through the year is at 21.4% growth for third-party products.

Operating profit NOK 113.3 million, up 55% over last year, also creating this very strong EBIT margin of 32.3% in the first half.

I think the biggest piece of news that we have really communicated through this year is the strengthening of our commercial operations, and I will refer to this towards the end of the presentation.

So with that introduction, we will go through the numbers in more detail by Thomas.

Thank you, Kari. I will take us through the financials, as usual. We will come back to revenue split per region and per product, so I will not comment that further here. But I need to mention and Kari touched upon it, that the reason for the improved gross margin is not related to cost saving of material, but the product mix. We sell more of our own products where we have the increase and especially in high-margin markets like the U.S.A. and we had less increase in third-party products. And therefore, we experienced an improved gross margin from 80% to 81.9%.

Salary and social expenses, yes, we have strengthened our commercial team, but we also have a very solid performance in AMERICAS and especially in the U.S.A., which then drives the commission expense for our sales team, obviously. But we also have other adjustments this year compared to last year and also some salary adjustments, which is a yearly thing.

Other operating expenses increases and this is due to increased travel activity related to our commercial team. They are out visiting customers, supporting them, closing sales, so forth. So we are much more -- having much more customer time out there and that drives expenses.

But all in all, this is a positive effect. We see an increased EBITDA from NOK 47.7 million to NOK 60.5 million and an EBITDA percent increase, almost 3%, ending at 35.8%.

Depreciation is at the same level as last year, and our operating profit ends at NOK 54.1 million up over 50%, as Kari mentioned, from last year and an improved margin from 28.5% to 32%. So very strong EBIT margin above 30%.

Net finance is positive. We have -- this is mainly related to currency, either realized gains or losses -- or unrealized gains and losses. In total, a net positive effect of NOK 2.2 million.

This leaves us with a profit before tax at NOK 56.3 million and profit after tax at NOK 42.9 million, up considerably compared to last year.

Then for the first half, again, the same explanations to many of the items. Although third-party products actually increased more than 20% in the first half, we have even stronger growth in sales of our own products, so that again drives the gross margin to a higher level and it's increasing from 80.6% to 82.5%.

Salary and social expenses, again, same explanation as for the quarter, but I would also like to add that we made additional accruals for annual bonuses since we now have excellent performance in the first half. We also looked at goals for the year in total and then also made accruals for those bonus that are related to annual goals. And since we are -- it's looking good that we are going to achieve this for the first half, we made a portion of that as an accrual in the accounts by the end of the first half.

Other operating expenses, travel is the driver, but we also have expenses related to our important project, the PATENT project this year, which we did not have last year. So those are the 2 main reasons for the cost increase there.

Operating profit before depreciation and amortization ends at NOK 125.2 million, up from NOK 86.1 million last year and a solid improvement in the percentage EBITDA from 30.9% to 35.7%.

Depreciation, a little bit lower than last year. That means some of the projects have already been depreciated.

Operating profit ends at NOK 113.3 million, which is up more than 50% with the top line increases 25%. Operating profit increase is more than 50%, and that's what we'd like to see.

EBIT percentage, 32.3%, up from 26.3% last year.

Net finance for the first half is actually negative -- slightly negative NOK 250,000.

Profit before tax ends at NOK 113.1 million and profit after tax is at NOK 86.4 million versus NOK 59.1 million last year. So a solid growth on the bottom line.

To the balance sheet. Fixed asset and intangible assets in total, same level as we entered the year in, but we do have an increase in intangible assets, which means that we are working on developing our own products, which are placed in the balance sheet. And the fixed assets is being reduced, which means that we have less investments in fixed assets that we now are depreciating.

Inventory levels are again a little bit up, but now we have really honored all those purchase orders that we had to place during the period of supply chain issues. So most of those are delivered. So we would expect to sell from inventory going forward. And therefore, we would expect also entering into 2026 that inventory levels will decrease since we now have -- don't need to place purchase orders on the major components to our products.

Customer receivables increases due to higher sales, which is natural.

And yes, we have a solid cash position, almost at the same level as last year, but keep in mind that we actually paid a dividend that was almost NOK 30 million higher this year compared to last year. So we are recovering quite fast when it comes to the cash position.

Equity. Total equity is more than 70% even after the NOK 110 million -- or NOK 109 million dividend payment in May.

We have no interest-bearing debt, that means bank debt towards the banks that we pay interest on. We do have long-term debts related to lease obligations and deferred income divided in long term and short term. So obviously, the short term is within 1 year and the long term is longer than 1 year. And that's why we have a long-term liability in the balance sheet.

Key figures. Earnings per share, solid improvement as we would expect when we have solid development -- or strong development in operating profit and profit after tax.

Cash flow. Even though we have a profit of more than NOK 100 million, the cash from operation ends at NOK 56.5 million. The main reason for that is prepayment of tax of NOK 28 million and we also have a change in working capital.

And even though we have an increase in inventory, the main driver for the change in working capital is actually customer receivables, which increases with NOK 28 million.

Investments ends at NOK 12.5 million. Mainly the majority of that is related to the development of our own products.

Cash from financing, obviously, dividend is the largest payout, but we also purchased our own shares in this period to honor a share program for management and key personnel in Medistim. And we also have the lease obligations, which also is reported under cash from financing, giving us a net negative cash from financing at NOK 126.8 million.

So net change in cash of NOK 82 million. We end the first half at NOK 96.3 million in cash.

And with that, I give word further on to Kari. Thank you.

Yes. So let's make a round trip looking at the various products. So as usual, starting with the high-value, higher-priced Flow-and-Imaging systems and looking at the unit sales development. We are seeing a very strong quarter from AMERICAS, which are selling 8 units more compared to the same period last year. But EMEA and Asia Pacific is slightly down, and that means that the net effect this quarter is 1 more Flow-and-Imaging system compared to the same period.

I think it's valuable to highlight also that for the first half, we are actually selling 12 more units of this Flow-and-Imaging system compared to the first half '24.

Imaging probes, we are selling 7 more than Q2 last year, up 23%. AMERICAS and EMEA is up. Asia Pacific slightly down on the imaging side. Year-to-date, we are selling 20 more units this year compared to the first half last year.

Flow-only systems in units, we see that we are up by 6 units. AMERICAS up 2 units, Asia Pacific up by 7 units. And we're seeing a little bit softness from EMEA this quarter, and it's due to less sales through our distributor sales network. Again, year-to-date or the first half, we are selling 13 more Flow units this year compared to last year .

When it comes to the number of flow probes sold in units, we see that the sales is up by 15.6% and it's up in all regions, although slightly for the quarter in EMEA. And year-to-date, we are seeing a 17% increase in number of flow probes. So this is a very solid evidence that there is new customers coming in buying the first probe packages, but also that we had good utilization on the installed base.

Looking a bit further into the regions and AMERICAS, as highlighted. NOK 78.9 million in sales in the second quarter. Currency-neutral, very strong growth of almost 33%. And we can see that it's the total number of systems sold as capital that is really driving this. And we also see that the majority of these systems are Flow-and-Imaging systems. So that, of course, drives revenue. It's a direct market, it's highly priced and it's a majority of Flow-and-Imaging systems. So that all contributes to the great results.

It's also great to see that our new direct market, Canada, is continuing to contribute to AMERICAS' good performance, growing 13.7% this quarter.

Latin America is a very small portion of the AMERICAS sales, and this quarter it's a little softer than normal.

Looking a little bit further into some details here, we can see in the table on the top here the number of capital units sold in U.S.A. So we can clearly see that we have sold more Flow systems and also more Flow-and-Imaging systems both for the quarter and for the first half. And we can see that the majority of systems sold is really on the Flow-and-Imaging side. So this is driving the revenue, as mentioned.

It's also interesting to see that the growth in flow probes to capital customers, which we see in the second table here at almost 50% growth, this is, of course, driving the total number of procedures that we are counting as well, and this is a great development. I just wanted to remind us that this is also driven by these initial probe packages that goes out to new customers. So it's not equal to utilization, but we are looking at these numbers as an estimate for utilization. And we can see that this is going in the right direction, definitely.

Also very nice to see and credit to the U.S. team that we are seeing 7 new customers for the quarter and actually 19 new customers achieved so far this year.

When it comes to the Asia Pacific region, as already mentioned, it is China who is really coming back. When we entered this year, we see that China is normalizing after this transition period. We've talked a lot about that. We went direct. And the distributor -- local distributor network in China was sort of filled up with products. So it was hard for Medistim to start selling in the first phase here. So '23 and '24 were challenging years.

Now in '25, we see that we are recovering from this period, and the sales is back to normal. So very strong growth in the second quarter from China, up 75%.

When it comes to Japan, we see for the quarter it was at the same level as last year, but we do see some growth in the first half from Japan. So a little bit better than we have seen in last year and the previous quarters.

It's also interesting to see that our sales to India is picking up. So this quarter, we sold for NOK 1.9 million and NOK 4 million in the first half. Of course, these are very modest numbers. But it's a very important strategic market for Medistim, as we've talked about many times. And we have worked together with LivaNova for a longer period in order to really establish a pipeline of projects and potential customers. And in this first half of the year, we're seeing that this is starting to pay off. So it will be very interesting to see whether we are able to continue this good trend in the second half, and of course, further on.

When it comes to EMEA, NOK 42.8 million in sales, slight downward trend for the quarter. But as already mentioned, we are growing in the first half.

What is always very positive to notice is that the direct markets, which are Spain, Germany, Scandinavia, are still growing and then not completely making up for the downward result for the quarter from our distributors. But it really points to the importance of Medistim's strategy, which is to go direct in more markets over time.

Third-party products. We started in the first quarter with a tremendous 41% growth. This is very unusual for the third-party portfolio, but this was driven by equipping some new hospitals in Norway. So we're back to a more modest growth this quarter, but still, of course, for the first half it's looking really, really nice with 21.4% growth.

And we are carrying a highly diversified product portfolio in this part of our business. And so far, it's Mentor, Icare and A.M.I., which are the biggest contributors. Ophthalmology, the ophthalmology portfolio, is the one that has contributed the most to the growth in the first half.

And this is summarizing the various geographical performances, and I don't think I will go through this in any detail.

Taking a look at how we're doing when we're splitting our own product sales into sales to cardiac surgeons and to vascular surgeons, we see that both portfolios are doing nicely, both for the quarter and also for the first half. But it's always very important for us to see that the vascular products are actually growing more than the average here and more than cardiac.

Of course, it's growing from a much smaller sales and we are investing a lot of efforts in order to develop this market. So it's very important that we are seeing a result from this.

41% growth in Vascular in the second quarter and 43% in the first half, that speaks to a very good development in Vascular.

Also, when it comes to the split between Flow-only products and Flow-and-Imaging products, it is, of course, important for us to see that the Imaging product portfolio is continuing to grow. Today, the Flow products is making up the majority of the sales revenues from our own products, around 70%, and around 30% of the revenues is coming from the Imaging products. But we know that we have a huge potential in converting the installed base on Flow-Only to Flow-and-Imaging. So to monitor progress and success in this portfolio is very, very important.

And then we also remember that we had a challenging period for the Imaging sales in 2023 and '24, very much related to a challenging macroeconomic environment. But we saw that towards the end of '24, and then into this year, the Imaging portfolio is coming back strongly, growing 37% in this quarter and 60% in the first half. So this is also very much in line with our own expectations. And the feedback we get from the market and from potential new customers that the interest in Imaging remains very strong.

When we look at the recurring sales versus capital revenues, we are seeing that we have very strong capital sales in the second quarter. So the share of recurring revenues are a bit lower for the quarter. We are at 66% compared to 73% in the second quarter last year. For the last 12 months period, we see that recurring revenue is at 70%, which is about the same level as last year.

So that was a deeper dive into some details on product performance. And then just some further comments with regard to our strategy and what we are working hard on there.

So our strategy, very briefly, is adapted to the various positions we have in the various markets. So we have strong Medistim markets where we had a high share in the CABG field. And here, of course, the main strategy is to convert the Flow-only to Flow-and-Imaging.

And then in developing markets where we have a lower position, it is really to grow this adoption through clinical marketing, education and also through the product innovation to make our products as easy to use and adopt as possible.

When it comes to some more price-sensitive markets such as India, we have also made it our strategy to being able to provide entry-level solutions in these markets.

Vascular surgery, a very important future growth area for the company. And we are very focused there in our strong CABG markets to make sure that this is going to be the next lever for growth. But also in the developing markets, we are pushing these products forward.

And finally, and as mentioned before, very important for us to continue to expand our direct market coverage.

I stated in January that due to the fact that 2025 started with a launch of the INTUI software platform for the Cardiac segment and also that we started to embark on the journey for a clinical study in peripheral bypass to really support our Vascular segment, this would be a perfect time for us to strengthen our commercial efforts.

And as talked about previously, we did make some changes to our commercial operations from January onwards. We got appointed a new Chief Commercial Officer. We had a new leader for the AMERICAS sales region. And we've also strengthened and expanded sales teams, especially in the AMERICAS with a few more heads and this will continue into the next year as well.

So this is not, of course, only a matter of putting more people in place, but it's also making sure that we are sharing best practices across regions. We have put more emphasis on training and support to our sales teams. And we are really seeing results from these endeavors already.

So we entered the year with our slogan, One team. Bold moves and Excellence redefined. We feel that we are making good progress on all of this.

And with that, I think we are ready to take some questions.

Yes. And we have quite a few coming in. The first one is on AMERICAS. The growth of more than 30% in AMERICAS is impressive. Can you elaborate on this development? Do you attribute the growth to your product offering, market conditions, new management in the region? Or is it down to other elements?

It's probably a good mix of the things that you are mentioning. Of course, we should keep in mind that the quarters that we are comparing with are softer than -- we were not happy with the first and second quarter in '24 with our sales.

At the same time, we have seen tremendous progress in the first half. We have seen that we are winning more customers. We are able to close more capital deals. We're also able to convince our prospects to actually invest in their flow and imaging systems, which is the higher value. So clearly, we are succeeding with our strategy here.

So I think it's a combination. We have a great leadership team in place. We have strengthened the team, as I've already mentioned. I think that also the focus that also Thomas, I think, mentioned that more expectations with regard to spending more time face-to-face with our customers, doing more clinical evaluations, those are all very important factors in order to succeed in this space.

So I guess, yes, it's a combination of all of that.

Yes. Thank you. What is the weighted average age of the installed base? Just trying to get a sense of the cohorts in place and when old systems would need to be upgraded. Of the 3,700 installed base, how many are still in use?

That's a difficult question, but most of them, I would say.

When we estimate this, we are actually looking at what we estimate as those being active. So when we say and report, I think in the latest report now, 3,850 systems active, those are system installed base. That's those who are active because we, over the years, sold more than that number of systems.

And also we see that, on average, a system is used around 100 times during a year. So that's how we kind of calculate how many systems that are active based upon our probe sales.

So those we report as 3,850 systems are the active ones that we estimate. And the lifetime of that system can vary. We've seen on the shorter term, more like 5 years, but we've also seen some of these systems lasting up to 10 years.

Thank you. The next one is on the inventory. I appreciate the need for an inventory buffer to ensure deliverability. But looking past that, your balance sheet looks highly conservative. Why not lever the balance sheet a bit to fund M&A and/or new buybacks or similar?

When it comes to our inventory, I mean, we do have the regulatory issues that forces us to make sure we have all the components that we need because if we miss one component, we can't sell our product, and that will be a catastrophe for Medistim.

And all those orders, as I mentioned, they have been honored. And going forward, we will sell from inventory. That means the most critical components that we have to secure, which are Medistim-based and it has to go through another regulatory process if we change them, those are secured for a couple of years ahead. So we don't have to place order on those components and products in the near future. Therefore, we expect an inventory decrease.

That's the answer to the inventory question.

When it comes to M&A, we have been looking at M&A earlier, and we also had a project on that last year really looking into what could be Medistim's opportunities. And yes, what we found was that a lot of opportunities there, but the conclusion for Medistim was that we do have so much opportunity within our own products and own markets that in order for us to focus on the potential that we actually have, we should really focus on the Medistim products and going forward with -- rather going direct in other markets and do product developments on our own products.

Maybe you want to add something to that, Kari.

Yes. And of course, M&A will never be out of the picture. We will always scan the market and be open for opportunities, but it's not a proactive strategy. As you say, we feel that we have a lower risk opportunity with our organic growth strategy and so much to grow from there. But we are following the market.

I think also with regard to financing M&A opportunity, we're not seeing that as a problem. I mean, we do have a very solid finance base. It would not be a problem for us to raise the money.

And the Board also has authority to issue shares if the right opportunity is there. And I can also add that what we've seen so far, we're afraid that an M&A would actually distract the opportunity that we have within the markets we're already in.

Thank you. Could you comment on your leg stimulator you showed at UCSF Vascular Symposium. Is this a new product? Or does it simplify your sales process or both?

That's interesting that someone has picked up on our new leg that we are actually using for demonstrating how to use our probes in vascular surgery. So it's -- we should have our marketing team really here to explain this, but it's something that we are using for demonstrations.

For now, we are using it at conferences, but it has proven to be a very effective tool to actually having vascular surgeons come and understand better how they can utilize our flow probes. So it's a tool that we are planning to use more in the future, and it's created some interesting attention out there. It's not a product, it's something we use for demonstrations.

The next one is on pricing. Can you clarify your pricing in the second quarter? You had mentioned raising prices with the software launch, which didn't happen at the start of the quarter. So when exactly do you increase prices and by how much?

And also regarding the new tariff, will you be able to pass this cost on fully to the customers?

When it comes to INTUI launch and the increased pricing, we haven't seen that in the first half because that has been launched now after, and then we will see hopefully effects on that in the second half when we get there.

When it comes to tariffs, there are still some uncertainties, but Norway has, it's been communicated, a tariff to Norway of 15%. And if we follow our business model and transfer pricing towards our U.S. subsidiary, we would have to absorb 9% to the end customer, which then would make this a zero-game.

We do have plans -- we did have plans even before the tariff to increase pricing and considerably more than 9% in the U.S. But when it comes to other markets, it's different. So we have to go into each and every region to evaluate how much we can actually raise the prices. But for the U.S., we will more than absorb the tariff.

And the effect of these price increases have not been shown in our numbers yet. So that's sort of an upside for the second half.

Yes. One more on INTUI. Are you already having a feeling for the demand for upgrading of the current installed base with the new software?

Well, it's a fact that actually taking the product all the way through our production into the market has been delayed. So we have only sold a few versions of our MiraQ with INTUI inside so far. So that's -- we can't really speak very much to the feedback from the early users in any meaningful way yet.

But still, there is -- from what we have shown at conferences and to other customers, there is definitely a great interest in the INTUI. And also the majority of new systems and MiraQs that we will be selling will be with INTUI inside. I mean, that will not be a choice. It's not like you're choosing INTUI or not. It's only for tender business that we have already sort of entered into we will sell the old legacy software.

Could you talk about your initiatives in R&D, given the R&D spend is significantly up year-over-year?

Well, I would say that it's starting to be at the level we need it to be. I think it's important to realize that Medistim's percentage of R&D spending, I mean, related to sales has been on the very low side compared to other players in the medical device.

The big projects that we have invested in, I mean, over the past few years has been very much on the INTUI side so improving the software that we are -- we've launched the first version of. But I've also said that there will be new upgrades of the software with new features being added as time moves forward. And it's been a revamp of the whole software also in the process. So that is also, of course, taken time and resources, and this is visible on the cost side.

We're also doing an automation project in our production, which has also been mentioned before that we are seeing at the possibility to automate several steps, as many as possible, in our production of the flow probes, which is today a very manual process.

These 2 projects have been taken the majority of the R&D costs in the past period, and I think will continue to be the basis for also spending going forward. But we also have some new products that we are in the starting phase to actually start developing as well. So we will come back with more details on that when the time comes.

Thank you. Are there specific markets you would like to go direct within the coming 1 to 2 years?

We always have a short list of the next markets where we want and plan to go direct, and we will also disclose that when the time comes.

And the last one is on AI. Could you talk about the use of AI, perhaps in conjunction with your new software, internal as well as for the surgeon?

Yes. So our dream is, of course, to apply AI on larger data sets in order to developing and offering more sophisticated interpretation guidance to our users, whether that is on the flow side of the technology or on the imaging side. And actually INTUI is a one -- first step in that direction because that software helps our users to better control where measurements are done. It's better reported. It provides a data basis for further analysis. And this is really required in order to get the quality data that we would need in order to develop interpretation -- guided interpretation, well, based on AI.

At the same time, we're also doing some experiments internally to see what we could develop. But as I said, we are depending on great data to really get that going.

That was all the questions from the web.

Then we thank you for participating this morning, and we will meet again for the third quarter. Thank you.

Thank you.