Doug Godshall: Yes. I mean it’s – this is a nuisance, not a fundamental change in the scale of the opportunity, more of a speed bump than a roadblock, if that could find different analogies. The effect is – and so zero change in opportunity. We have near-term some caution, which is what we are trying to communicate today that we think turns in – it turns into a BTK growth engine starting next year. And then we pick up reimbursement in OBLs and have other product launches for above the knee and above the knee becomes a significant growth driver in a way are we backing away from what we think is an enormous opportunity in peripheral, both above the knee and below knee with big chunky growth vehicles just not in the next kind of six months.
So, a little bit of a reset on the near-term because of this more aggressive implementation of a pre-existing policy for those Aetna covered lives, private and Medicare Advantage administered Aetna kind of patients. So, it’s a big enough population because Aetna is pretty big, that if every – if a lot of centers have a little bit of a drag on their patients, it’s enough, given our – the breadth of our installed base, which we are very proud of, like it adds up when one, two [ph] patients adds up across a broad spectrum of doctors. It’s not enough where the doctors are like I mean some doctors are very frustrated because they have a lot of that patients. Other doctors, yes, I lost a patient or two patients last month, but I will get them back once I win the argument.
So, it’s not a fundamental sort of this is such an aggressive change that suddenly pad procedures are going to drop precipitously. They are just going to not grow and our business is not going to grow as much in the very near-term.
Isaac Zacharias: I would just add there are many centers because this isn’t a policy change. I mean this policy has been in place from all the providers getting for peripheral arterial disease. Some centers have a – they work with the policy already. They have a smooth machine for doing it. The doctors don’t even know it happens. Other centers, this is that low. You are changing how our patients flow and they are not set up to deal with the change. So, I think the likelihood is centers who are doing big peripheral volume who are having this roadblock put up by Aetna, they will figure out administratively how to deal with the roadblock and smooth things out going forward.
Danielle Antalffy: Got it. That’s helpful. And then just on the coronary, we are always so focused on center adds there, but actually not every interventional cardiologist has adopted Shockwave IVL in each center. So, just curious about the incremental utilization potential within the existing centers, if you can somehow frame the opportunity that way, that would be helpful. Thanks so much.
Isaac Zacharias: Yes, it’s a good question. So, to your point, we have kind of completed adding centers a number of quarters ago for the most part. And so where we are getting the growth of revenue is sort of two places with physicians who have adopted us as a part of their treatment algorithm as the economics improve and as they get more experience with Shockwave moving earlier in the PCI to use Shockwave if there is calcium. That – and we have experienced with physicians who do that, they tend to say the cases are smoother. They don’t get in trouble so much. There is less gear used if they use Shockwave earlier when the calcium is there. So, that’s kind of we call that moving kind of up the treatment algorithm. And the second place for growth is physicians within that hospital who haven’t really adopted us.
And that’s, I think a rich area for us. And what we are doing on that front is at the business planning level for the territories, really a focus on understanding which doctors are practicing at the hospital, they move around sometimes within areas and which of those physicians are utilizing Shockwave, why and why not. And then that’s helping our team target physicians in the hospital and getting them to adopt. So, that’s sort of the thrust of the growth going forward.
Danielle Antalffy: Thank you so much.
Operator: There are no further questions in the queue. I would like to hand the call back to Doug Godshall for closing remarks.
Doug Godshall: Thanks very much, and thanks all of you for your time and attention. Look forward to seeing you – many of you later this quarter. Have a good day.
Operator: Ladies and gentlemen, this does conclude today’s teleconference. Thank you for your participation. You may disconnect your lines at this time and have a wonderful day.
