Inari Medical (NARI) in late May had a Director purchase 56,100 shares at $53.44/share for nearly $3M, which followed a 56,100 share purchase at the same price in November 2023 and now owns more than 3.25M shares. NARI came public in 2020 near $40 and quickly ascended to $120 but shares have trended lower since May 2021. NARI is a market leader in a fast-growing segment of med-tech.

NARI builds a variety of products, including minimally invasive, novel, catheter-based mechanical thrombectomy devices and their accessories to address the unique characteristics of specific disease states. NARI acquired LimFlow S.A. in November 2023, a medical device company focused on limb salvage for patients with chronic limb-threatening ischemia (CLTI). CLTI is an advanced stage of peripheral artery disease that is associated with increased mortality, risk of amputation and impaired quality of life. The LimFlow system utilizes transcatheter arterialization of deep veins (TADV) to bypass blocked arteries in the leg and deliver oxygenated blood back into the foot via the veins in CLTI patients. NARI, in total, has solutions to address the following disease states: deep vein thrombosis, pulmonary embolism, arteriovenous (AV) thrombosis primarily in dialysis fistulas or grafts, acute limb ischemia (ALI), chronic venous disease, and CLTI.

NARI has a $2.5B market cap and trades 3.7X EV/Sales with revenues seen rising 15-20% annually the next two years. NARI should see a step-up in profitability in coming years and FY27 EPS forecasts currently at $1/share and positive FCF inflection seen for FY25. The VTE market has a long runway of growth and though concerns of competition launches/upgrades have weighed on shares, NARI remains the leader and there is plenty of room for multiple players. An ongoing DOJ inquiry has also been an overhang, but NARI has a strong balance sheet to manage a settlement.

NARI management estimates that the VTE market is only 6% penetrated and likely headed to 60% and sees an opportunity for growth with a continued shift patients from being treated with lytic-based interventions and, most importantly, with conservative medical management. NARI remains the market leader with 4:1 sure advantage over the next nearest market participant in mechanical thrombectomy for PE and 1.5x, 2x lead over the next nearest market participant for mechanical thrombectomy for DVT.

NARI continues to execute the regulatory path approvals for both China and Japan, and they remain on track for helping patients in both of those respective markets. Both markets are large opportunities for the company, particularly China due to its population size and unmet need. The company remains committed to presenting the results of the PEERLESS study at a meeting later this year. PEERLESS II trial and DEFIANCE are readouts further down the road attacking the large opportunity which is the conservative medical management and the use of anticoagulant drugs. The recently launched VenaCore device for CVD is also receiving positive physician feedback.

Analysts have an average target of $66 and short interest is elevated at 7.9% of the float. Deutsche Bank started coverage at Buy with a $68 target in early August saying mechanical thrombectomy technology penetration to move steadily higher over the next several years which will yield robust revenue growth for NARI. Baird has a $63 target positive into Q4 catalysts and increasing international contribution.