 Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Cellini. I'm a diagnostic radiologist, subspecializing in interventional radiology in New York City. On today's video, we are going to be talking about another medical stock, specifically a company that is very involved in the interventional radiology space, which is my space, and goes by the name of Inari ticker symbol N-A-R-I. And as an interventional radiologist, I feel like I have a unique perspective on this company, especially since I have used their device on many occasions. So before I go any further, let's go ahead and get into it. Let's do a deep dive on Inari, and make sure you stay til the end to see if I'm going to be investing in this stock. Let's go. So as usual, before we start this video, I have to give a quick disclaimer and state that I am a physician and I am in no way shape or form giving you financial advice. What you do with your money is your decision and yours alone. Do not listen to anything I say. I hope I make myself clear. Please take everything I say and everybody else on YouTube with a grain of salt. Now let's get into the video. All right, so I'm going to break this video down the same way I did my past video on Nanox, link up here. First, we're going to talk about what is Inari. Second, we're going to talk about what products or services they offer. Third, we're going to talk about what I think of the company. And fourth, we're going to talk about will I invest in the company? So let's first start off with what is Inari? Let's go over here. So let's start off the first section here, what is Inari? We'll go ahead and pull up their website in NariMedical.com. Right off the bat, we see Inari Medical extracting large clots from large vessels without need of thrombolytics or ICU stay. Since 2000, more than 170 thrombectomy devices have been cleared by the FDA and nearly all of them have been designed for arterial system. The repurposing of these devices for venous clot is suboptimal due to clot morphology and vessel size, which is true. As a result, treatments include or rely exclusively upon thrombolytic drugs and their inherent bleeding risk. They go into a little more depth about how veins are low flow, low pressure and arteries that are high flow and high pressure. Vains are usually larger, arteries are usually smaller. That's why they can't make a device for veins and arteries. It has to be different. Then they go on and talk about venous clots are firm and hard and adhere to the vessel. While in arterial clots are a little different, they kind of float in the vessel and don't adhere as much. All right. So what products or services does Inari offer? Focusing on the critical vessels of venous disease, Inari has designed tools to treat both pulmonary embosom and deep vein thrombosis or DBT. They believe that removing flat matters and it should be done safely. The flow-triever and clot-triever were designed as non-thrombolytic solutions to venous thrombolinalism with that belief in mind. And yes, those are the two names of the two products they offer. One, the flow-triever and two, the clot-triever. The clot-triever I don't really care about as much because I've only used the flow-triever, but I'll get into the flow-triever first. Oh, but before I get into that, let's go ahead and mention that both devices have been FDA cleared for removal of emboli and thrombi from peripheral vasculature. Also, this is very, very, very important that the flow-triever was the first mechanical thrombectomy device awarded FDA indication for treatment for pulmonary embolism. This is huge, huge, huge, but more on that later as well. So let's get into the flow-triever, shall we? So this is a large bore over-the-wire system designed to remove clot via mechanical and aspiration mechanisms, capture and remove large clot burden from big vessels, treat in a single session, eliminate need for thrombolytics, and also eliminate the ICU stay. Some of these are very important and I'll touch on them a bit later as well. So make sure you stay tuned till the end for this because a lot of this stuff is pretty important. I'll go ahead and play a little bit from this video so you can get a sense and idea of how this system actually works and why it's so important. The Treever 20 features a highly trackable, large lumen catheter and large bore syringe designed to rapidly extract large volumes of clot while limiting blood loss. Upon gaining ultrasound-guided venous access, a guide wire is advanced past the target clot in the pulmonary artery. With the dilator in place, the Treever 20 is advanced over the wire until it reaches the target clot. The dilator is removed and with the flush port stopcock closed, the syringes pulled back and locked into place. Opening the stopcock releases the vacuum and creates a high flow, volume capped aspiration minimizing blood loss while drawing clot through a continuous lumen into the syringe. So essentially we place a large 24 French catheter or eight millimeters in diameter, almost like the size of this pen if you can get a feel. So then using our X-ray machine or live X-ray also known as fluoroscopy, we advance this large caliber tube into the right atrium of the heart through the tract husband valve with the right heart into the right ventricle and into the main pulmonary artery and we can go to the left or right main pulmonary arteries from there. Like I said, we do this under X-ray guidance or fluoroscopy. And once we're in the right or left main pulmonary artery, we essentially just aspirate or pull back the 60cc syringe, which is a large or 60cc syringe to match the 24 French hole that the catheter has. We can essentially just suck out the clot from the pulmonary arteries. If some of the clot is difficult to remove, we can actually use the flow-triever device, but I probably only use this one time and it didn't really work that well. I'm more so in this for the actual suction thrombectomy through the large bore catheter because the ability to kind of track this large bore catheter into the pulmonary arteries and remove the PE is the essential part of an artery in my opinion. So now let's talk about the clot-triever, which like I said, I've never actually used, but clot-triever isn't over the wire system, used a core clot from a vein wall, can capture, remove large clot burden from a large vessel, treat in a single session, eliminate need for thrombolytics and also eliminate ICU stay. If you wanna watch the video on this device, just go to thehinarimedical.com and go to clot-triever. You can watch the video as well. I'm not going to kind of get into that in the interest of time. But before I do any further, I wanna thank Policy Genius for sponsoring today's video. If you have a family with members that depend on your income, you pretty much need life insurance. It's that simple. So then why is buying life insurance so complicated? Well, it's no longer complicated because Policy Genius has reinvented this process from start to finish. You could save $1,300 or more per year by using Policy Genius to compare life insurance policies. Policy Genius is an insurance marketplace, not an insurance company. In minutes, you can work out how much coverage you need and compare personalized quotes to find your best price. The best thing about Policy Genius is that it is easy to apply online. 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So you have a 65 year old female coming to the ER with shortness of breath, chest pain, can't speak in full sentences without taking a breath and requiring large amounts of oxygen to keep their saturations up. You do a CT scan and show large pulmonary emboli. You don't have to be a medicine to know that this is a very common and serious situation in which immediate intervention is required, otherwise the outcome can be fatal. Now we have a device where we can essentially bring them to our IR suite, put the catheter through their heart into their pulmonary arteries, suck out all the clot and under an hour and immediately watch their oxygen requirements go down. That's incredible. We basically have a device to essentially reverse a PE if it happens. And let's not forget the treatment for a pulmonary embolism if they actually made it through the pulmonary embolism used to be surgery until this device came along. Well, not this device, but suction from back to me devices. Now, don't get me wrong, it doesn't always have a 100% success rate as these patients can be very hemodynamically unstable and the smallest thing can disrupt them and set them over the edge. So you can imagine tracking a large bore catheter through the heart can do just that. However, a lot of times this may be the last resort for patients and most of the time the benefits of doing the procedure outweigh the risks because if you don't do something the patient may pass away. So let's talk about their competitors. Their main competitor is a company called Panombra. They make a device very similar. However, it's essentially half the size and doesn't work as well. It's more maneuverable given its smaller size but the actual aspiration is just not as powerful and in my experience doesn't work as well. I genuinely believe there is no device that can match the power of the inari suction from back to me device. And I say that from someone who has used the device many times. For example, I'll even throw up a video clip of me using this device a couple of months ago or so. More than the device itself, I want to touch on a few other points that were important and I mentioned them earlier. The first point I like to make is the treatment in a single session. This device literally requires only one session. You bring the patient in, you suck out the clot, that's it. In the past we've had to bring the patients in, put up infusion catheters, put them in the ICU overnight as this clot busting drug is infused directly into the pulmonary arteries which has risks of bleeding throughout the body spontaneously, then we would bring it back the next day and assess how well it works. This is just a one and done treatment and it's a huge win for all parties involved. The second point I like to make and mention earlier is that you completely eliminate ICU stays. This is huge and here's why. Usually like I said, after an open surgery or placing infusion catheters, the patient would have to stay in the ICU to monitor them at the higher level of care they need. Now a patient can have this procedure in under an hour sometimes and go straight to a step down or floor bed not requiring ICU level of care. The reason is because the patient has such an immediate result after the procedure. Patients love this because they don't have to do on the ICU which is expensive to them and they also don't have to have clot busting medication run through their body which can cause spontaneous bleeds in the abdomen or even brain and hospitals love this even more because there are set bundled reimbursement codes for pulmonary embolism. These are bundled codes that average the cost of all pulmonary emboli in the past which involves ICU stays and pays the hospital a set reimbursement rating for those codes. The reason hospitals love it is because that reimbursement bundle payment relies on all-inclusive payment for PEs in the past and nowadays using this device it may not require everything grouped into that cost and I know that's kind of confusing but I'll give you an example. So I'm just gonna make up random numbers for an example here but say for instance a bundle payment for a hospital pays the hospital $60,000. That includes ICU level of care maybe one or two multiple nights I don't really know but we're just using an example here. Since using this device does not require ICU level of care a lot of the times it may only cost the hospital $20,000 for that PE instead of the usual average $60,000 which means the hospital collects an additional $40,000 and they didn't use the resources that require it. I hope this makes sense. Now you see why hospital administrators would love this device. Now it is pretty expensive like $10,000 or so for this device each use but if you're making $20,000 per use then a $10,000 profit isn't that bad. All right so now the moment you've all been waiting for am I going to be investing in this company? I think you can tell by my strong feelings on this company that the answer is a resounding yes. In fact I've been an investor for about seven months now just after they IPO'd last May. When I first saw this product in action during the first few weeks of my interventional radiology fellowship I literally went straight to Fidelity, found the Anari ticker symbol and invested that day. That's how excited I was about the device. Currently it's trading around $110 a share but by the time this video comes out I anticipate it's higher, well hopefully. Furthermore pulmonary embolism research is still relatively new and ongoing and this Anari device could become the gold standard for treatment of pulmonary embolisms going forward so I'm actually pretty excited about the future for Anari. So on that note that officially concludes this video let me know in the comments below what you think of Anari and if you're going to invest in Anari. If you're interested in a particular medical biotech or healthcare stock and want me to do a deep dive on it let me know in the comments below as well. Otherwise make sure you smash that like and subscribe button it really helps out the channel. Follow me on TikTok and Instagram and I'll see you all on the next video.