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Avinger Inc

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FY2020 Annual Report · Avinger Inc
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SECURITIES & EXCHANGE COMMISSION EDGAR FILING

Avinger Inc

Form: 10-K 

Date Filed: 2021-03-11

Corporate Issuer CIK:   1506928

© Copyright 2021, Issuer Direct Corporation. All Right Reserved. Distribution of this document is strictly prohibited, subject to the terms of use.

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 10-K

(Mark One)

  ☒

  ☐

ANNUAL REPORT PURSUANT TO SECTION  13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF  1934

TRANSITION REPORT PURSUANT TO SECTION  13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF  1934

For the Fiscal Year Ended December  31, 2020
or

Commission File Number: 001-36817

AVINGER, INC.
(Exact name of registrant as specified in its charter)

Delaware
(State or other jurisdiction of
incorporation or organization)

20-8873453
(I.R.S. Employer
Identification Number)

400 Chesapeake Drive
Redwood City, California 94063
(Address of principal executive offices and zip code)
(650) 241-7900
(Telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class:
Common Stock, par value $0.001 per share

Trading Symbol(s):
AVGR

Name of each exchange on which registered
The Nasdaq Capital Market

Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934
during  the  preceding  12  months  (or  for  such  shorter  period  that  the  registrant  was  required  to  file  such  reports),  and  (2)  has  been  subject  to  such  filing
requirements for the past 90 days. Yes ☒ No ☐

Indicate  by  check  mark  whether  the  registrant  has  submitted  electronically  every  Interactive  Data  File  required  to  be  submitted  pursuant  to  Rule  405  of

Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an
emerging  growth  company.  See  the  definitions  of  “large  accelerated  filer,”  “accelerated  filer,”  “smaller  reporting  company,”  and  “emerging  growth  company”  in
Rule 12b-2 of the Exchange Act.

Large accelerated filer ☐
Accelerated filer ☐
Non-accelerated filer ☒
Smaller reporting company ☒
Emerging growth company  ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new

or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes ☐ No ☒

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal
control  over  financial  reporting  under  Section  404(b)  of  the  Sarbanes-Oxley  Act  (15  U.S.C.  7262(b))  by  the  registered  public  accounting  firm  that  prepared  or
issued its audit report.  ☐

The aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant, based on the closing price of a share of
the  registrant’s  common  stock  on  June  30,  2020,  the  last  business  day  of  the  registrant’s  most  recently  completed  second  fiscal  quarter,  as  reported  by  the
Nasdaq Global Market on such date, was approximately $16.8 million. This calculation does not reflect a determination that certain persons are affiliates of the
registrant for any other purpose.

As of February 26, 2021, the number of outstanding shares of the registrant’s common stock, par value $0.001 per share, was 95,298,129.

None.

DOCUMENTS INCORPORATED BY REFERENCE

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
AVINGER, INC.
ANNUAL REPORT ON FORM 10-K
FOR THE FISCAL YEAR ENDED DECEMBER 31, 2020
TABLE OF CONTENTS

Part I
Item 1. Business
Item 1A. Risk Factors
Item 1B. Unresolved Staff Comments
Item 2. Properties
Item 3.
Item 4. Mine Safety Disclosures

Legal Proceedings

Part II
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Item 6. Selected Financial Data
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Item 7A. Quantitative and Qualitative Disclosures About Market Risk
Item 8.
Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Item 9A. Controls and Procedures
Item 9B. Other Information

Financial Statements and Supplementary Data

Part III
Item 10. Directors, Executive Officers and Corporate Governance
Item 11. Executive Compensation
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Item 13. Certain Relationships and Related Transactions, and Director Independence
Item 14. Principal Accountant Fees and Services

Part IV
Item 15. Exhibits and Financial Statement Schedules
Item 16. Form 10-K Summary
Signatures

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“Avinger,”  “Pantheris,”  “Lumivascular,”  and  “Tigereye”  are  trademarks  of  our  company.  Our  logo  and  our  other  trade  names,  trademarks  and  service
marks appearing in this Annual Report on Form 10-K are our property. Other trade names, trademarks and service marks appearing in this Annual Report on
Form 10-K are the property of their respective owners. Solely for convenience, our trademarks and trade names referred to in this Annual Report on Form 10-K
appear without the ™ symbol, but those references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our
rights, or the right of the applicable licensor to these trademarks and trade names.

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

This Annual Report on Form 10-K contains forward-looking statements concerning our business, operations and financial performance and condition, as
well as our plans, objectives and expectations for our business, operations and financial performance and condition. Any statements contained herein that are not
statements of historical facts may be deemed to be forward-looking statements. In some cases, you can identify forward-looking statements by terminology such
as “anticipate,” “assume,” “believe,” “contemplate,” “continue,” “could,” “due,” “estimate,” “expect,” “goal,” “intend,” “may,” “objective,” “plan,” “predict,” “potential,”
“positioned,”  “seek,”  “should,”  “target,”  “will,”  “would”  and  other  similar  expressions  that  are  predictions  of  or  indicate  future  events  and  future  trends,  or  the
negative of these terms or other comparable terminology. These forward-looking statements include, but are not limited to, statements about:

•

•

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•

•

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the outcome of and expectations regarding our current clinical studies, and any additional clinical studies we initiate;

our plans to modify our current products, or develop new products, to address additional indications;

our ability to obtain additional financing through future equity or debt financings;

the expected timing of 510(k) clearances by the FDA for enhanced versions of Pantheris, Ocelot and Lightbox;

the expected timing of 510(k) submission to the FDA, and associated marketing clearances by the FDA, for additional versions of Pantheris, Ocelot
and Lightbox;

the expected growth in our business and our organization;

our expectations regarding government and third-party payor coverage and reimbursement, including the ability of Pantheris and Ocelot to qualify for
reimbursement codes used by other atherectomy products;

our ability to remain in compliance with the listing requirements of the Nasdaq Capital Market;

our ability to retain and recruit key personnel, including the continued development of our sales and marketing infrastructure;

our ability to obtain and maintain intellectual property protection for our products;

our estimates of our expenses, ongoing losses, future revenue, capital requirements and our needs for, or ability to obtain, additional financing;

our  expectations  regarding  revenue,  cost  of  revenue,  gross  margins,  and  expenses,  including  research  and  development  and  selling,  general  and
administrative expenses;

our expectations of qualitative and quantitative effects of COVID-19 to the extent discussed, as well as any expectations of recovery from or forward
looking short-term or long-term implications thereof;

the effects of the COVID-19 pandemic on our business and results of operations;

our ability to identify and develop new and planned products and acquire new products;

our financial performance;

our ability to remain in compliance with laws and regulations that currently apply or become applicable to our business, both in the United States and
internationally; and

developments and projections relating to our competitors or our industry.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We believe that it is important to communicate our future expectations to our investors. However, there may be events in the future that we are not able to
accurately predict or control and that may cause our actual results to differ materially from the expectations we describe in our forward-looking statements. These
forward-looking statements are based on management’s current expectations, estimates, forecasts and projections about our business and the industry in which
we operate and management’s beliefs and assumptions and are not guarantees of future performance or development and involve known and unknown risks,
uncertainties  and  other  factors  that  are  in  some  cases  beyond  our  control.  As  a  result,  any  or  all  of  our  forward-looking  statements  in  this  Annual  Report  on
Form 10-K may turn out to be inaccurate. Factors that may cause actual results to differ materially from current expectations include, among other things, those
listed in Part I, Item 1A under “Risk Factors” and elsewhere in this Annual Report on Form 10-K. We urge you to consider these factors carefully in evaluating the
forward-looking statements. These forward-looking statements speak only as of the date of this Annual Report on Form 10-K. We assume no obligation to update
or revise these forward-looking statements for any reason, even if new information becomes available in the future.

You should not rely upon forward-looking statements as predictions of future events. Although we believe that the expectations reflected in the forward-
looking  statements  are  reasonable,  we  cannot  guarantee  that  the  future  results,  levels  of  activity,  performance  or  events  and  circumstances  reflected  in  the
forward-looking statements will be achieved or occur. Except as required by law, we undertake no obligation to update publicly any forward-looking statements
for any reason after the date of this Annual Report on Form 10-K to conform these statements to actual results or to changes in our expectations.

You  should  read  this  Annual  Report  on  Form  10-K  and  the  documents  that  we  reference  in  this  Annual  Report  on  Form  10-K  and  have  filed  with  the
United States Securities and Exchange Commission (“SEC”) as exhibits to the Annual Report on Form 10-K with the understanding that our actual future results,
levels of activity, performance and events and circumstances may be materially different from what we expect.

2

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
ITEM 1.     BUSINESS

Overview

PART I

We  are  a  commercial-stage  medical  device  company  that  designs,  manufactures  and  sells  image-guided,  catheter-based  systems  that  are  used  by
physicians to treat patients with peripheral artery disease, or PAD. Patients with PAD have a build-up of plaque in the arteries that supply blood to areas away
from the heart, particularly the pelvis and legs. Our mission is to significantly improve the treatment of vascular disease through the introduction of products based
on our Lumivascular platform, the only intravascular image-guided system available in this market.

We design, manufacture, and sell a suite of products in the United States and select international markets. We were formed as a Delaware corporation in
2007. Our principal offices are located in Redwood City, California. Our current Lumivascular platform consists of products include our Lightbox imaging console,
the Ocelot family of catheters, which are designed to allow physicians to penetrate a total blockage in an artery, known as a chronic total occlusion, or CTO, and
the Pantheris family of catheters, our image-guided atherectomy family of catheters which is designed to allow physicians to precisely remove arterial plaque in
PAD patients. We received CE Marking for our original Ocelot product in September 2011 and received from the U.S. Food and Drug Administration, or FDA,
510(k) clearance in November 2012. We received 510(k) clearance from the FDA for commercialization of Pantheris in October 2015. We received an additional
510(k) clearance for an enhanced version of Pantheris in March 2016 and commenced sales of Pantheris in the United States and select European countries
promptly thereafter. In May 2018, we received 510(k) clearance from the FDA for our current next-generation version of Pantheris. In April 2019, we received
510(k) clearance from the FDA for our Pantheris SV, a version of Pantheris targeting smaller vessels, and commenced sales in July 2019. The Pantheris SV has
a smaller diameter and longer length that we believe will optimize it for its targeted use.

In  September  of  2020,  we  received  510(k)  clearance  of  Tigereye,  a  next-generation  CTO  crossing  system  utilizing  Avinger’s  proprietary  image-guided
technology  platform.  Tigereye  is  a  product  line  extension  of  Avinger’s  Ocelot  family  of  image-guided  CTO  crossing  catheters.  Its  design  elements  include  an
upgrade  of  the  image  capture  rate  to  provide  high  definition,  real-time  intravascular  imaging  similar  to  the  company’s  Pantheris  image-guided  atherectomy
system and a user-controlled deflectable tip designed to assist in steerability within the lumen. Tigereye also features a new distal tip configuration with faster
rotational  speeds  designed  to  penetrate  challenging  lesions.  The  Tigereye  catheter  has  a  working  length  of  140  cm  and  5  French  sheath  compatibility  for
treatment  of  lesions  in  the  peripheral  vessels  both  above  and  below  the  knee.  The  product  became  available  in  October  2020  for  first  cases  in  the  U.S  on  a
limited basis and launched commercially in January 2021.

Current  treatments  for  PAD,  including  bypass  surgery,  can  be  costly  and  may  result  in  complications,  high  levels  of  post-surgery  pain,  and  lengthy
hospital stays and recovery times. Minimally invasive, or endovascular, treatments for PAD include stenting, angioplasty, and atherectomy, which is the use of a
catheter-based device for the removal of plaque. These treatments have limitations in their safety or efficacy profiles and frequently result in recurrence of the
disease,  also  known  as  restenosis.  We  believe  one  of  the  main  contributing  factors  to  high  restenosis  rates,  or  narrowing  of  a  blood  vessel,  for  PAD  patients
treated  with  endovascular  technologies  is  the  amount  of  vascular  injury  that  occurs  during  an  intervention.  Specifically,  these  treatments  often  disrupt  the
membrane between the outermost layers of the artery, which is referred to as the external elastic lamina, or EEL.

We believe our Lumivascular platform is the only technology that offers real-time visualization of the inside of the artery during PAD treatment through
the  use  of  optical  coherence  tomography,  or  OCT,  a  high  resolution,  light-based,  radiation-free  imaging  technology.  Our  Lumivascular  platform  provides
physicians with real-time OCT video images from the inside of an artery, and we believe Ocelot and Pantheris are the first product families to offer intravascular
visualization during CTO crossing and atherectomy, respectively. We believe this approach will significantly improve patient outcomes by providing physicians
with a clearer picture of the artery using radiation-free video image guidance during treatment, enabling them to better differentiate between plaque disease and
healthy arterial structures. Our Lumivascular platform is designed to improve patient safety by enabling physicians to direct treatment towards the plaque disease,
while avoiding damage to healthy portions of the artery.

During the first quarter of 2015, we completed enrollment of patients in VISION, a clinical trial designed to support our August 2015 510(k) submission to
the FDA for our Pantheris atherectomy device. VISION was designed to evaluate the safety and efficacy of Pantheris to perform atherectomy using intravascular
imaging  and  successfully  achieved  all  primary  and  secondary  safety  and  efficacy  endpoints.  We  believe  the  data  from  VISION  allows  us  to  demonstrate  that
avoiding damage to healthy arterial structures, and in particular disruption of the external elastic lamina, which is the membrane between the outermost layers of
the artery, reduces the likelihood of restenosis, or re-narrowing, of the diseased artery. Although the original VISION study protocol was not designed to follow
patients beyond six months, we worked with 18 of the VISION sites to re-solicit consent from previous clinical trial patients in order for them to evaluate patient
outcomes through 12 and 24 months following initial treatment. Data collection for the remaining patients from participating sites was completed in May 2017,
and we released the final 12- and 24-month results for a total of 89 patients in July 2017.

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During the fourth quarter of 2017, we began enrolling patients in INSIGHT, a clinical trial designed to support a submission to the FDA to expand the
indication  for  our  Pantheris  atherectomy  device  to  include  in-stent  restenosis.  Patient  enrollment  began  in  October  2017  and  is  expected  to  continue  through
2021.  Patient  outcomes  will  be  evaluated  at  thirty  days,  six  months  and  one  year  following  treatment.  We  plan  to  submit  a  510(k)  application  with  the  FDA
seeking a specific indication for treating in-stent restenosis with Pantheris once the trial is fully enrolled and follow-up data through six months are available and
analyzed.

We continue development efforts on the next-generation of the Lightbox imaging console, the Lightbox 3, which is being designed to provide enhanced

real-time video imaging capabilities in a much smaller form factor and at a lower cost. We anticipate filing a 510(k) submission for the Lightbox 3 during 2021.

We  focus  our  direct  sales  force,  marketing  efforts  and  promotional  activities  on  interventional  cardiologists,  vascular  surgeons  and  interventional
radiologists. We also work on developing strong relationships with physicians and hospitals that we have identified as key opinion leaders. Although our sales and
marketing efforts are directed at these physicians because they are the primary users of our technology, we consider the hospitals and medical centers where the
procedure  is  performed  to  be  our  customers,  as  they  typically  are  responsible  for  purchasing  our  products.  We  are  designing  additional  future  products  to  be
compatible  with  our  Lumivascular  platform,  which  we  expect  to  enhance  the  value  proposition  for  hospitals  to  invest  in  our  technology.  Pantheris  qualifies  for
existing reimbursement codes currently utilized by other atherectomy products, further facilitating adoption of our products.

We  have  assembled  a  team  with  extensive  medical  device  development  and  commercialization  experience  in  both  start-up  and  large,  multi-national
medical  device  companies.  We  assemble  all  of  our  products  at  our  manufacturing  facility  but  certain  critical  processes,  such  as  coating  and  sterilization,  are
performed  by  outside  vendors.  We  expect  our  current  manufacturing  facility  in  California,  will  be  sufficient  through  at  least  2021.  We  generated  revenues  of
$7.9  million  in  2018,  $9.1  million  in  2019  and  $8.8  million  in  2020.  The  growth  experienced  in  2019  was  largely  due  to  our  next-generation  Pantheris  and  the
launch of Pantheris SV. The decline in 2020 was primarily due to the adverse effects of COVID-19 on our customers as hospitals deferred elective procedures
which is discussed in greater detail in other parts of this section.

Our Products

Our current products include our Lightbox imaging console and our various catheters used in PAD treatment. All of our revenues are currently derived
from sales of our various PAD catheters and Lightbox imaging console and related services in the United States and select international markets. Each of our
current products is, and our future products will be, designed to address significant unmet clinical needs in the treatment of vascular disease.

LUMIVASCULAR PRODUCTS

Name
PRODUCTS

Lightbox (1)

Clinical
Indication

Size
(Length,
Diameter)

Regulatory
Status

Original
Clearance Date

OCT Imaging

 N/A

FDA Cleared
CE Marking
FDA Cleared
CE Marking
FDA Cleared
CE Marking
FDA Cleared
CE Marking
  FDA Cleared
FDA Cleared
CE Marking
FDA Cleared
CE Marking

November 2012
September 2011
April 2019
October 2018
May 2018
December 2017
November 2012
September 2011
  December 2012
December 2012
October 2012
September 2020
December 2019

Pantheris SV (small vessel) (2)

Atherectomy

140cm, 6F

Pantheris (next-generation) (3)

Atherectomy

110cm, 7F

Ocelot (4)

Ocelot MVRX (4)
Ocelot PIXL (4)

Tigereye (4)

PIPELINE PRODUCTS
Lightbox 3 (5)

(1) Lightbox is cleared for use with compatible Avinger products.

CTO Crossing

110cm, 6F

CTO Crossing
CTO Crossing

  110cm, 6F

135/150cm, 5F

CTO Crossing

140cm, 5F

OCT Imaging

   N/A

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(2) The Pantheris SV system is intended to remove plaque (atherectomy) from partially occluded vessels in the peripheral vasculature with a reference diameter
of  2.0  mm  to  4.0  mm,  using  OCT-assisted  orientation  and  imaging.  The  system  is  an  adjunct  to  fluoroscopy  by  providing  images  of  vessel  lumen,  wall
structures and vessel morphologies. The Pantheris SV system is contraindicated for use in the iliac, coronary, cerebral, renal or carotid vasculature.

(3) The Pantheris system is intended to remove plaque (atherectomy) from partially occluded vessels in the peripheral vasculature with a reference diameter of
3.0 mm to 7.0 mm, using OCT-assisted orientation and imaging. The system is an adjunct to fluoroscopy by providing images of vessel lumen, wall structures
and vessel morphologies. The Pantheris system is contraindicated for use in the iliac, coronary, cerebral, renal or carotid vasculature.

(4) The Ocelot system is intended to facilitate the intra-luminal placement of conventional guidewires beyond stenotic lesions including subtotal and chronic total
occlusions in the peripheral vasculature prior to further percutaneous interventions using OCT-assisted orientation and imaging. The system is an adjunct to
fluoroscopy and provides images of vessel lumen, plaques and wall structures. The Ocelot system is contraindicated for use in the iliac, coronary, cerebral,
renal and carotid vasculature.

(5) The  Lightbox  3  is  being  designed  to  provide  enhanced  video  imaging  capabilities  in  a  much  smaller  form  factor  and  to  be  available  at  a  lower  cost.  We

anticipate filing a 510(k) submission for the Lightbox 3 during 2021.

NON-IMAGING PRODUCTS

Sales of Wildcat and Kittycat 2 have declined and are continuing to decline as we focus on the promotion of our Lumivascular platform products.

Name
Wildcat (1)

Kittycat 2 (2)

Size
(Length,
Diameter)

  110cm, 6F
110cm, 6F

Indication
Guidewire Support
CTO Crossing

CTO Crossing

  150cm, 5F

Regulatory
Status
  FDA Cleared
FDA Cleared
CE Marking
  FDA Cleared
CE Marking

Original
Clearance Date

  February 2009(3)

August 2011
May 2011

  October 2011

September 2011

(1) The Wildcat catheter is intended to facilitate the intraluminal placement of conventional guidewires beyond stenotic lesions (including subtotal and chronic
total occlusions) in the peripheral vasculature prior to further percutaneous intervention. The Wildcat catheter is contraindicated for use in the iliac, coronary,
cerebral,  renal  and  carotid  vasculature.  The  Wildcat  catheter  is  intended  to  be  used  to  support  steerable  guidewires  in  accessing  discrete  regions  of  the
peripheral vasculature. It may be used to facilitate placement and exchange of guidewires and other interventional devices. It may also be used to deliver
saline or contrast.

(2) The Kittycat 2 catheter is intended to facilitate the intraluminal placement of conventional guidewires beyond stenotic lesions (including subtotal and chronic
total  occlusions)  in  the  peripheral  vasculature  prior  to  further  percutaneous  intervention.  The  Kittycat  2  catheter  is  contraindicated  for  use  in  the  iliac,
coronary, cerebral, renal and carotid vasculature.

(3) This original clearance date is for the 7F version of Wildcat. The commercially available version of Wildcat is listed and was cleared in August 2010.

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Lumivascular Platform Overview

Our Lumivascular platform integrates OCT (optical coherence tomography) visualization with interventional catheters and is the industry’s only system
that  provides  real-time  intravascular  imaging  simultaneously  with  treatment  in  PAD  procedures.  Our  Lumivascular  platform  consists  of  a  capital  component,
Lightbox, and a variety of disposable catheter products, including the Ocelot and Pantheris family of catheters.

Lightbox

Lightbox is our proprietary video imaging console, which enables the use of Lumivascular catheters during PAD procedures. The console contains an
optical  transceiver  that  transmits  light  into  the  artery  through  an  optical  fiber  and  displays  a  cross-sectional  image  of  the  vessel  to  the  physician  on  a  high-
definition monitor during the procedure.

Lightbox displays a cross-sectional view of the vessel, which provides physicians with detailed information about the orientation of the catheter and the
surrounding  artery  and  plaque.  Layered  structures  represent  relatively  healthy  portions  of  the  artery  and  non-layered  structures  represent  the  plaque  that  is
blocking  blood  flow  in  the  artery.  Navigational  markers  allow  the  physician  to  orient  the  catheter  toward  the  treatment  area,  helping  to  avoid  damage  to  the
healthy arterial structures during a procedure. Lightbox received FDA 510(k) clearance in November 2012 and CE Marking in Europe in September 2011. We are
in  the  process  of  developing  a  next-generation  imaging  console,  Lightbox  3,  with  a  reduced  footprint  and  improved  technology.  We  anticipate  filing  a  510(k)
submission for Lightbox 3 in 2021 and plan to commercially launch in the United States once pre-market clearance is received by the FDA.

Pantheris

We  believe  Pantheris  is  the  first  atherectomy  catheter  to  incorporate  real-time  OCT  intravascular  video  imaging.  Pantheris  may  be  used  alone  or
following  a  CTO  crossing  procedure  using  Ocelot  or  other  products.  Pantheris  is  a  single-use  product  and  provides  physicians  with  the  ability  to  see  a  cross-
sectional view of the peripheral artery to guide the removal of blockages throughout the procedure. The Pantheris device restores blood flow by shaving strips of
plaque using a high-speed directional cutting mechanism that enables physicians to specifically target the portion of the artery where the plaque resides while
minimizing  disruption  to  healthy  arterial  structures.  The  excised  plaque  is  deposited,  collected  and  contained  into  the  nosecone  of  the  Pantheris  device  and
removed from the artery within the device.

In  October  2015,  we  received  510(k)  clearance  from  the  FDA  for  commercialization  of  Pantheris.  We  made  modifications  to  Pantheris  after  the
completion of the VISION trial and commenced sales in the United States and select international markets following receipt of FDA approval for this initial version
of Pantheris in March 2016. We first received CE Marking for Pantheris in June 2015. We received CE Marking in December 2017 and 510(k) clearance in May
2018 for a next-generation version of Pantheris, which includes new features and design improvements to the handle, shaft, balloon and nosecone of the device.
The next-generation Pantheris atherectomy device is currently available for commercial sale in the United States and select international markets. All previous
versions of Pantheris have been discontinued.

We  also  developed  a  line  extension  of  our  Pantheris  image-guided  atherectomy  platform,  Pantheris  SV  (Small  Vessel),  a  lower  profile  version  of
Pantheris. The Pantheris SV has a smaller diameter and longer length and is designed for use in smaller vessels 2.0 to 4.0 millimeters in diameter. We received
CE Marking in October 2018 and 510(k) clearance in April 2019 for this product and commenced sales in the United States in July 2019.

Ocelot and Tigereye

We believe Ocelot is the first CTO crossing catheter to incorporate real-time OCT video imaging, which allows physicians to see the inside of a peripheral
artery during a CTO crossing procedure. Physicians have traditionally relied solely on fluoroscopy and tactile feedback to guide catheters through complicated
blockages. Ocelot allows physicians to accurately navigate through CTOs by utilizing the OCT images to precisely guide the device through the arterial blockage,
while minimizing disruption to the healthy arterial structures. A successful CTO crossing and placement of a guidewire allows the physician to subsequently treat
the vessel with a minimally invasive therapeutic device. We received CE Marking for Ocelot in September 2011 and received FDA 510(k) clearance in November
2012.

We  also  offer  Ocelot  PIXL,  a  lower  profile  CTO  crossing  device  for  below-the-knee  arteries  and  Ocelot  MVRX,  which  offers  a  different  tip  design  for
peripheral  arteries  above  the  knee.  We  received  CE  Marking  for  Ocelot  PIXL  in  October  2012  and  received  FDA  510(k)  clearance  in  December  2012.  We
received FDA 510(k) clearance for Ocelot MVRX in December 2012.

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Tigereye is a product line extension of our Ocelot family of image-guided CTO crossing catheters. Its design elements include an upgrade of the image
capture rate to provide high definition, real-time intravascular video imaging similar to the company’s Pantheris image-guided atherectomy system and a user-
controlled deflectable tip designed to assist in steerability within the artery’s lumen. Tigereye also features a new unique state-of-the-art distal tip configuration
with faster rotational speeds designed to penetrate challenging lesions. The Tigereye catheter has a working length of 140 cm and 5 French sheath compatibility
for treatment of lesions in the peripheral vessels both above and below the knee. We received CE Marking for Tigereye in December 2019 and received FDA
510(k) clearance in September 2020. The product became available in the fourth quarter of 2020 for first cases in the U.S with a full commercial launch following
shortly thereafter in the first quarter of 2021.

Other Products

Our first-generation CTO crossing catheters, Wildcat and Kittycat 2, employ a proprietary design that uses a rotational spinning technique, allowing the
physician to switch between passive and active modes when navigating across a CTO. Once across the CTO, Wildcat and Kittycat 2 allow for placement of a
guidewire and removal of the catheter while leaving the wire in place for additional therapies. Both products require the use of fluoroscopy solely rather than our
Lumivascular  (OCT-guided)  platform  for  imaging.  Wildcat  was  our  first  commercial  product  and  has  both  FDA  510(k)  clearance  in  the  United  States  and  CE
Marking in Europe for crossing peripheral artery CTOs. Kittycat 2 has FDA 510(k) clearance in the United States and CE Marking in Europe for the treatment of
peripheral artery CTOs. Sales of Wildcat and Kittycat 2 have declined and are continuing to decline as we focus on the promotion of our Lumivascular platform
products.

Clinical Development

We  have  conducted  several  clinical  trials  to  evaluate  the  safety  and  efficacy  of  our  products  in  both  pre-market  and  post-market  assessments.  We
received  FDA  clearance  for  Wildcat  and  Ocelot  for  CTO  crossing  in  2011  and  2012,  respectively,  and  for  Pantheris  in  October  2015,  following  completion  of
clinical trials of the devices.

CONNECT (Wildcat)

Our clinical trial for the Wildcat catheter, known as the CONNECT trial, was a prospective, multi-center, non-randomized trial that evaluated the safety
and  efficacy  of  Wildcat  in  crossing  CTOs  in  arteries  of  the  upper  leg.  The  CONNECT  trial  enrolled  88  patients  with  CTOs  at  15  centers  in  the  United  States.
Patients  were  followed  for  30  days  post-procedure  and  an  independent  group  of  physicians  verified  the  results  to  determine  crossing  efficacy  and  safety
endpoints.  The  CONNECT  trial  demonstrated  that  Wildcat  was  able  to  cross  89%  of  CTOs  following  unsuccessful  attempts  to  cross  with  standard  guidewire
techniques, which is the second-highest reported CTO crossing rate of any published CTO clinical trial. In addition, use of the device was extremely safe, with
95% free from vessel wall perforations and no incidences of major adverse events, embolization, or grade C dissections. These results are exceeded only by our
subsequent CONNECT II clinical trial results.

CONNECT II (Ocelot)

Our clinical trial for Ocelot, known as CONNECT II, was a prospective, multi-center, non-randomized trial that evaluated the safety and efficacy of Ocelot
in crossing CTOs in arteries of the upper leg using OCT intravascular imaging. The CONNECT II trial enrolled 100 patients with CTOs at 13 centers in the United
States and 2 centers in Europe. Patients were followed for 30 days post-procedure and an independent group of physicians verified the results to confirm the
primary  efficacy  and  safety  endpoints.  Results  from  the  CONNECT  II  trial  demonstrated  that  Ocelot  surpassed  its  primary  efficacy  endpoint  by  successfully
crossing  the  CTO  in  97%  of  the  cases  following  unsuccessful  attempts  to  cross  with  standard  guidewire  techniques.  Ocelot  achieved  these  rates  with  98%
freedom from MAEs.

VISION (Pantheris)

VISION  was  our  pivotal,  non-randomized,  prospective,  single-arm  trial  to  evaluate  the  safety  and  effectiveness  of  Pantheris  across  20  sites  within  the
United  States  and  Europe.  The  objective  of  the  clinical  trial  was  to  demonstrate  that  Pantheris  can  be  used  to  effectively  remove  plaque  from  diseased  lower
extremity arteries while using on-board visualization as an adjunct to fluoroscopy. Two groups of patients were treated in VISION: (1) optional roll-ins, which are
typically the first two procedures at a site, and (2) the primary cohort, which are the analyzable group of patients. The data for these two groups were reported
separately in our 510(k) submission to the FDA. Based on final enrollment, the primary cohort included 130 patients. In March 2015, we completed enrollment of
patients in the VISION clinical trial and we submitted for 510(k) clearance from the FDA in August 2015. In October 2015, we received 510(k) clearance from the
FDA  for  commercialization  of  Pantheris.  We  made  modifications  to  Pantheris  subsequent  to  the  completion  of  VISION  and  received  510(k)  clearance  on  the
enhanced version of Pantheris in March 2016 and received 501(k) clearance in May 2018 for a next-generation version of Pantheris, which includes new features
and design improvements to the handle, shaft, balloon and nose cone of the device as well as 510(k) clearance in April 2019 for Pantheris SV, a lower profile
Pantheris.

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VISION’s primary efficacy endpoint required that at least 87% of lesions treated by physicians using Pantheris have a residual stenosis of less than 50%,
as verified by an independent core laboratory. The primary safety endpoint required that less than 43% of patients experience an MAE through six-month follow-
up as adjudicated by an independent Clinical Events Committee, or CEC. MAEs as defined in VISION included cardiovascular-related death, unplanned major
index  limb  amputation,  clinically  driven  target  lesion  revascularization,  or  TLR,  heart  attack,  clinically  significant  perforation,  dissection,  embolus,  and
pseudoaneurysm. Results from the VISION trial demonstrated that Pantheris surpassed its primary efficacy and safety endpoints; residual restenosis of less than
50% was achieved in 96.3% of lesions treated in the primary cohort, while MAEs were experienced in 16.6% of patients.

Although not mandated by the FDA to support the market clearance of Pantheris, the protocol for the VISION trial allowed for routine histopathological
analysis of the tissue extracted by Pantheris to be conducted. This process allowed us to determine the amount of adventitia present in the tissue, which in turn
indicated the extent to which the external elastic lamina had been disrupted during Pantheris procedures. We completed histopathological analysis on tissue from
129 patients in the primary cohort, representing 162 lesions and determined that the average percent area of adventitia was only 1.0% of the total excised tissue.
We  believe  the  low  level  of  EEL  disruption  will  correlate  to  lower  restenosis  rates  and  improved  long-term  outcomes  for  patients  treated  with  Pantheris.  We
published the results of the histopathological analysis in conjunction with the primary safety and efficacy endpoint data from the VISION trial.

Final VISION trial data are summarized in the table below.

Patients Treated

Lesions treated
Primary Efficacy Endpoint

Lesions analyzed by core lab
Lesions meeting primary efficacy endpoint criterion of residual restenosis of less than

50% by core lab

Primary Safety Endpoint (MAEs through 6  months)

Total MAEs Reported
Reported MAEs as a percentage of patients enrolled

Histopathology Results (Non-Endpoint Data)

Lesions with histopathology results
Average percent area of adventitia in all lesions with histopathology results

Roll-In
Cohort

Primary
Cohort

Total

28 

34 

34 

130 

164 

164 

100%   

(34/34)  

96.3%   

(158/164)  

3 
11.5%   
(3/26)  

34 
0.56%   

22 
17.6%   

(22/125)  

162 
1.02%   

158 

198 

198 

97%

(192/198)

25 
16.6%

(25/151)

196 
0.94%

Although the original VISION study protocol was not designed to follow patients beyond six months, in 2016 we began working with 18 of the VISION
sites  to  re-consent  patients  in  order  for  them  to  be  evaluated  for  patient  outcomes  through  12  and  24  months  following  initial  treatment.  Data  collection  for
patients  from  participating  sites  was  completed  in  May  2017,  and  we  released  the  final  12-  and  24-month  results  for  a  total  of  73  patients  and  89  lesions  in
July 2017. The key metrics reported for this group were freedom from target lesion revascularization, or TLR, at 12 months and 24 months, which were 82% and
74% by patient and 83% and 76% by lesion, respectively, based on Kaplan-Meier curve assessments.

INSIGHT (Pantheris)

INSIGHT is a prospective, global, single-arm, multi-center study to evaluate the safety and effectiveness of Pantheris for treating in-stent restenosis in
lower extremity arteries. In-stent restenosis occurs when a blocked artery previously treated with a stent becomes narrowed again, thereby reducing blood flow.
Physicians  often  face  challenges  when  treating  in-stent  restenosis  both  in  terms  of  safety  and  efficacy.  From  a  safety  standpoint,  limitations  in  imaging
techniques, such X-ray fluoroscopy, and the inability to control the directionality of other atherectomy devices create concerns with impacting the integrity of the
stent  during  the  procedure.  In  terms  of  efficacy,  current  therapies  for  in-stent  restenosis,  such  as  balloon  angioplasty,  have  high  rates  of  recurrent  narrowing
within stents.

The INSIGHT trial allows for up to 140 patients to be treated at up to 20 sites in the United States and Europe. Patient enrollment began in October 2017
and  will  continue  through  2021.  Patient  outcomes  will  be  evaluated  at  thirty  days,  six  months  and  one  year  following  treatment.  We  plan  to  submit  a  510(k)
application with the FDA seeking a specific indication for treating in-stent restenosis with Pantheris once the data through six months are available and analyzed.

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Other Studies

We are pursuing additional clinical data programs including a post-market study, IMAGE-BTK, which is designed to evaluate the safety and efficacy for

Pantheris SV in the treatment of PAD lesions below-the-knee.

Sales and Marketing

We  focus  our  sales  and  marketing  efforts  primarily  on  the  approximately  10,000  interventional  cardiologists,  vascular  surgeons  and  interventional
radiologists  in  the  United  States  that  are  potential  users  of  our  Lumivascular  platform  products.  Our  marketing  efforts  are  focused  on  developing  strong
relationships  with  physicians  and  hospitals  that  we  have  identified  as  key  opinion  leaders  based  on  their  knowledge  of  our  products,  clinical  expertise  and
reputation. We also use continuing medical education programs and other opportunities to train interventional cardiologists, vascular surgeons, and interventional
radiologists in the use of our Lumivascular platform products and educate them as to the benefits of our products as compared to alternative procedures such as
angioplasty,  stenting,  bypass  surgery  or  other  atherectomy  procedures.  In  addition,  we  work  with  physicians  to  help  them  develop  their  practices  and  with
hospitals to market themselves as centers of excellence in PAD treatment by making our products available to physicians for treating patients.

Our  sales  team  currently  consists  of  a  Vice  President,  a  Regional  Director,  Territory  Sales  Managers,  Clinical  Specialists,  and  one  Vice  President  of
International  Sales.  Territory  Sales  managers  are  responsible  for  all  product  sales,  which  include  disposable  catheters  and  sale  and  service  of  our  Lightbox
console,  while  Clinical  Specialists  are  primarily  responsible  for  case  coverage  and  account  support.  We  have  an  extensive  hands-on  sales  training  program,
focused  on  our  technologies,  Lumivascular  image  interpretation,  case  management,  sales  processes,  sales  tools  and  implementing  our  sales  and  marketing
programs and compliance with applicable federal and state laws and regulations. Our sales team is supported by our marketing team, which focuses primarily on
clinical training and education, marketing communications and product management. We have partnered with a third-party field service firm for the installation,
service and maintenance of our Lightbox consoles.

No single customer accounted for more than 10% of our revenues during 2020 or 2019.

Competition

The  medical  device  industry  is  highly  competitive,  subject  to  rapid  change  and  significantly  affected  by  new  product  introductions,  results  of  clinical
research,  reimbursement  dynamics,  corporate  combinations  and  other  factors  relating  to  our  industry.  Because  of  the  market  opportunity  and  the  high  growth
potential of the PAD treatment market, competitors and potential competitors have historically dedicated, and will continue to dedicate, significant resources to
aggressively develop and commercialize their products.

Our  products  compete  with  a  variety  of  products  or  devices  for  the  treatment  of  PAD,  including  other  CTO  crossing  devices,  stents,  balloons  and
atherectomy catheters, as well as products used in vascular surgery. Large competitors in the CTO crossing, stent and balloon market segments include Abbott
Laboratories, AngioDynamics, Becton Dickinson, Boston Scientific, Cardinal Health, Cook Medical, Medtronic and Philips. Competitors in the atherectomy market
include AngioDynamics, Boston Scientific, Cardiovascular Systems, Medtronic and Philips. Some competitors have attempted to combine intravascular imaging
with  atherectomy  and  although  we  are  not  aware  of  any  active  initiatives  in  this  area,  these  and  other  companies  may  attempt  to  incorporate  on-board
visualization into their products in the future or may have ongoing programs of which we are not aware. Other competitors include pharmaceutical companies that
manufacture drugs for the treatment of symptoms associated with mild to moderate PAD and companies that provide products used by surgeons in peripheral and
coronary bypass procedures. These competitors and other companies may introduce new products that compete with our solution.

Many of our competitors have substantially greater financial, manufacturing, marketing and technical resources than we do. Furthermore, many of our
competitors  have  well-established  brands,  widespread  distribution  channels  and  broader  product  offerings,  and  have  established  stronger  and  deeper
relationships with target customers.

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To compete effectively, we have to demonstrate that our products are attractive alternatives to other devices and treatments on the basis of:

•

•

•

•

•

•

•

procedural safety and efficacy;

acute and long-term outcomes;

ease of use and procedure time;

third-party reimbursement;

size, effectiveness, and productivity of sales force;

radiation exposure for physicians, hospital staff and patients; and

price.

Intellectual property

In  order  to  remain  competitive,  we  must  develop  and  maintain  protection  of  the  proprietary  aspects  of  our  technologies.  We  rely  on  a  combination  of

patents, copyrights, trademarks, trade secret laws and confidentiality and invention assignment agreements to protect our intellectual property rights.

It  is  our  policy  to  require  our  employees,  consultants,  contractors,  outside  scientific  collaborators  and  other  advisors  to  execute  non-disclosure  and
assignment of invention agreements on commencement of their employment or engagement. Agreements with our employees also forbid them from using the
proprietary rights of third parties in their work for us. We also require confidentiality or material transfer agreements from third parties that receive our confidential
data or materials.

As of December 31, 2020, we held 38 issued and allowed U.S. patents, 1 U.S. pending provisional application, 23 U.S. utility patent applications and 2
PCT applications pending. As of December 31, 2020, we also had 75 issued and allowed patents from outside of the United States. As of December 31, 2020, we
had  40  pending  patent  applications  outside  of  the  United  States,  including  in  Australia,  Canada,  China,  Europe,  India,  Japan  and  Mexico.  As  we  continue  to
research  and  develop  our  products  and  technology,  we  intend  to  file  additional  U.S.  and  foreign  patent  applications  related  to  the  design,  manufacture  and
therapeutic uses of our devices. Our issued patents expire between the years 2028 and 2037.

Our patent applications may not result in issued patents and our patents may not be sufficiently broad to protect our technology. Any patents issued to us
may be challenged by third parties as being invalid, or third parties may independently develop similar or competing technology that avoids our patents. The laws
of certain foreign countries do not protect our intellectual property rights to the same extent as do the laws of the United States.

As of December 31, 2020, we held six registered U.S. trademarks. In Europe, we hold three registered trademarks. In addition, we held one International

Registration under the Madrid Protocol with granted extensions to China, Europe, Japan, and Korea (reflected in the three European registration noted above).

Research and Development

Our  ongoing  research  and  development  activities  are  primarily  focused  on  improving  and  enhancing  our  Lumivascular  platform,  specifically  our  core
competency of integrating OCT intravascular imaging onto therapeutic catheters. Our research objectives target areas of unmet clinical need, increase the utility
of the Lumivascular platform and adoption of our products by healthcare providers.

•

•

Product  line  improvements  and  extensions.   We  are  developing  improvements  to  our  Lumivascular  platform,  including  additional  catheters  for  use  in
different  clinical  applications.  For  example,  we  are  developing  next-generation  CTO  crossing  devices  to  target  both  the  peripheral  and  coronary  CTO
markets.

Additional treatment indications. We intend to seek additional regulatory clearances from FDA to expand the indications for which our products can be
marketed within PAD, as well as in other areas of the body. This includes both expanding the marketed indications for our current products, as well as
development of new products.

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•

•

Next-generation console. We are focusing our console development efforts on miniaturization, equipment integration and increased processing power in
anticipation  of  future  catheter  products.  We  may  also  develop  a  version  of  our  Lumivascular  platform  that  integrates  OCT  imaging  into  existing
catheterization lab and operating room imaging systems.

Improved  software  and  user  interface.   We  intend  to  further  develop  our  software  to  provide  more  information  and  control  to  our  end  users  during  a
procedure. We use physician and staff feedback to improve the features and user functionality of our Lumivascular platform.

In addition to our internal team, we retain third-party contractors from time to time to provide us with assistance on specialized projects. We also work

closely with experts in the medical community to supplement our internal research and development resources.

Manufacturing

All of our products are manufactured in-house using components and sub-assemblies fabricated both at our facility in Redwood City, California and by
key qualified outside vendors. We assemble all of our finished products at our manufacturing facility but certain critical processes such as coating and sterilization
are done by specialized outside vendors. We expect our current manufacturing facility will be sufficient through at least 2021.

Order  quantities  and  lead  times  for  components  purchased  from  outside  suppliers  are  based  on  our  forecasts  derived  from  historical  demand  and
anticipated  future  demand.  Lead  times  for  components  may  vary  significantly  depending  on  the  size  of  the  order,  time  required  to  fabricate  and  test  the
components, specific supplier requirements and current market demand for the components and subassemblies. To date, we have not experienced significant
delays in obtaining any of our components or subassemblies.

We rely on single and limited source suppliers for several of our components and sub-assemblies. For example, we rely on single vendors for our optical
fiber,  coating  and  drive  cables  that  are  key  components  of  our  catheters,  and  we  rely  on  single  vendors  for  our  laser  and  data  acquisition  card  that  are  key
components of our Lightbox. These components are critical to our products and there are relatively few alternative sources of supply for them. Identifying and
qualifying additional or replacement suppliers for any of the components used in our products could involve significant time and cost. Any supply interruption from
our vendors or failure to obtain additional vendors for any of the components used to manufacture our products would limit our ability to manufacture our products
and could therefore harm our business, financial condition and results of operations.

Our manufacturing operations are subject to regulatory requirements of 21 CFR part 820 of the Federal Food, Drug and Cosmetic Act, or FFDCA; the
Quality System Regulation, or QSR, for medical devices sold in the United States, which is enforced by FDA; the Medical Devices Directive 93/42/EEC, which is
required for doing business in the European Union; and applicable requirements relating to the environment, waste management and health and safety matters,
including measures relating to the release, use, storage, treatment, transportation, discharge, disposal and remediation of hazardous substances, and the sale,
labeling,  collection,  recycling,  treatment  and  disposal  of  products  containing  hazardous  substances.  We  cannot  ensure  that  we  will  not  incur  material  costs  or
liability in connection with our operations, or that our past or future operations will not result in claims by or injury to employees or the public.

Other  than  through  vendor  accepted  purchase  orders,  our  suppliers  have  no  contractual  obligations  to  supply  us  with,  and  we  are  not  contractually
obligated to purchase from them, any of our supplies. Any supply interruption from our vendors or failure to obtain additional vendors for any of the components
would limit our ability to manufacture our products and could have a material adverse effect on our business, financial condition and results of operations.

We  have  registered  with  FDA  as  a  medical  device  manufacturer  and  have  obtained  a  manufacturing  license  from  the  California  Department  of  Public
Health, or CDPH. We and our component suppliers are required to manufacture our products in compliance with FDA’s QSR in 21 CFR part 820 of the FFDCA.
The  QSR  regulates  extensively  the  methods  and  documentation  of  the  design,  testing,  control,  manufacturing,  labeling,  quality  assurance,  packaging,  storage
and  shipping  of  our  products.  FDA  enforces  the  QSR  through  periodic  unannounced  inspections  that  may  include  the  manufacturing  facilities  of  our
subcontractors. Our Quality System has undergone 20 external audits by third-parties and regulatory authorities since 2009, the latest of which was a surveillance
audit conducted in January 2017 by BSI, our European Notified Body, under the Medical Device Single Audit Program, or MDSAP. The audit resulted in zero
observations  of  non-conformances.  In  2018  and  2019,  BSI  conducted  multiple  routine  audits  including  surveillance  audit,  Microbiology  audit,  a  MDSAP  re-
certification audit and most recently, a one-day unannounced audit in September 2019. All non-conformances identified in the aforementioned audits have been
either successfully resolved or are being actively addressed via Avinger’s CAPA system.

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Our failure or the failure of our component suppliers to maintain compliance with the QSR requirements could result in the shutdown of our manufacturing
operations  or  the  recall  of  our  products,  which  would  harm  our  business.  In  the  event  that  one  of  our  suppliers  fails  to  maintain  compliance  with  our  or
governmental quality requirements, we may have to qualify a new supplier and could experience manufacturing delays as a result. We have opted to maintain
quality assurance and quality management certifications to enable us to market our products in the member states of the European Union, the European Free
Trade  Association  and  countries  which  have  entered  into  Mutual  Recognition  Agreements  with  the  European  Union.  Our  Redwood  City  facilities  meet  the
requirements  set  forth  by  ISO  13485:2003  Medical  devices—Quality  management  systems—Requirements  for  regulatory  purposes  and  MDD  93/42/EEC
European Union Council Medical Device Directive.

Government Regulation

In general, medical device companies must navigate a challenging regulatory environment. In the United States the FDA regulates the medical device
market to ensure the safety and efficacy of these products. The FDA allows for two primary pathways for a medical device to gain approval for commercialization:
(i) a pre-market notification or 510(k) submission based upon being equivalent to a device already in commercial distribution (a predicate device) or (ii) a PMA
(pre-market  approval).  A  completely  novel  product  must  go  through  the  more  rigorous  PMA  process  if  it  cannot  receive  authorization  through  a  510(k)
submission.  The  FDA  has  established  three  different  classes  of  medical  devices  that  indicate  the  level  of  risk  associated  with  using  a  device  and  consequent
degree of regulatory controls needed to govern its safety and efficacy. Class I and Class II devices are considered to have minimal risk to the user. Some Class I
and almost all Class II devices gain clearance for commercial distribution following review of an application to the FDA, generally known as the 510(k) process.
The devices regarded as the highest risk by the FDA are designated Class III and generally require the submission of a PMA application for approval prior to
commercialization.  Class  III  devices  generally  include  life-sustaining,  life-supporting,  or  implantable  devices  or  devices  without  a  known  predicate  technology
already approved by the FDA.

The 510(k) clearance path can be significantly less time-consuming and less arduous than PMA approval, making this route generally preferable for a
medical device company. A 510(k) application must include documentation that its device is substantially equivalent to a technology already cleared through a
510(k) or in distribution before May 28, 1976, and for which the FDA has not required a PMA submission. The FDA has 90 days from the date of the pre-market
equivalence acceptance to authorize or decline commercial distribution of the device. However, similar to the PMA process, clearance may take longer than this
three-month window, as the FDA can request additional data to support the submission. If the FDA resolves that the product is not substantially equivalent to a
predicate device, then the device acquires a Class III designation, and a PMA must be approved before the device can be commercialized. All of our currently
marketed  products  have  received  commercial  clearance  and  associated  indications  for  use  through  the  510(k)  regulatory  pathway,  some  with  the  support  of
clinical data.

After a device receives 510(k) clearance, any modification that could significantly affect its safety or effectiveness, or that would constitute a change in its
intended use, requires an additional 510(k) submission and clearance before the modified device can be commercialized. The FDA allows each manufacturer to
make this determination initially, but the FDA can review any such decision and can disagree with the manufacturer’s determination. If the FDA disagrees with
the determination not to seek a new 510(k) clearance or PMA the FDA may retroactively require a new 510(k) clearance or pre-market approval for the modified
device.  The  FDA  could  also  require  a  manufacturer  to  cease  marketing  and  distribution  of  the  modified  device  and/or  recall  the  modified  device  until
510(k)  clearance  or  PMA  approval  is  obtained.  Also,  in  these  circumstances,  a  manufacturer  may  be  subject  to  significant  regulatory  fines,  penalties,  and
enforcement actions.

A  PMA  application  must  include  reasonable  scientific  and  clinical  data  that  demonstrates  the  device  is  safe  and  effective  for  the  intended  uses  and
indications  being  sought.  The  application  must  also  include  preclinical  testing,  technical,  manufacturing  and  labeling  information.  If  the  FDA  determines  the
application can undergo substantive review, it has 180 days to review the submission, but it can typically take longer (up to several years) as this regulatory body
can  request  additional  information  or  clarifications.  The  FDA  may  also  impose  additional  regulatory  hurdles  for  a  PMA,  including  the  institution  of  an  advisory
panel  of  experts  to  assess  the  application  or  provide  recommendations  as  to  whether  to  approve  the  device.  Although  the  FDA  in  the  end  approves  or
disapproves the device, in nearly all cases the FDA follows the recommendation from the advisory panel. As part of this process, the FDA will usually inspect the
manufacturing facilities and operations prior to approval to verify compliance with quality control regulations. Significant changes in the manufacturing of a device,
or  changes  in  the  intended  use,  indications  and  labeling  or  design  of  a  product  require  new  PMA  applications  or  PMA  supplements  for  a  product  originally
approved under a PMA. This creates substantial regulatory risk for devices undergoing the PMA route.

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Pervasive and Continuing Regulation

After a device is placed on the market, numerous regulatory requirements continue to apply. These include:

•

•

•

the  FDA’s  QSR  (quality  system  regulation)  that  requires  manufacturers,  including  third-party  manufacturers,  to  follow  stringent  design,  testing,  control,
documentation and other quality assurance procedures during all aspects of the manufacturing process;

labeling regulations and FDA prohibitions against the promotion of products for uncleared, unapproved or off-label uses;

clearance or approval of product modifications that could significantly affect safety or efficacy or that would constitute a major change in intended use;

• medical device reporting, or MDR, regulations, that require manufacturers report to the FDA if their device may have caused or contributed to a death or

serious injury or malfunctioned in a way that would likely cause or contribute to a death or serious injury if the malfunction were to recur; and

•

post-market surveillance regulations, which apply when necessary to protect the public health or to provide additional safety and effectiveness data for
the device.

We are registered with the FDA as a medical device manufacturer and have obtained a manufacturing license from the California Department of Public
Health (CDPH). The FDA has broad post-market and regulatory enforcement powers. We are subject to unannounced inspections by the FDA and the Food and
Drug Branch of CDPH to determine our compliance with the QSR and other regulations, and these inspections may include the manufacturing facilities of our
suppliers.  Our  current  facility  has  been  inspected  by  the  FDA  in  2009,  2011  and  2013,  and  two,  three  and  zero  observations,  respectively,  were  noted  during
those  inspections.  In  the  latest  FDA  audit  in  2013,  there  were  no  observations  that  involved  a  material  violation  of  regulatory  requirements,  and  no  non-
conformances  were  noted.  Our  responses  to  the  observations  noted  in  2009  and  2011  were  accepted  by  the  FDA,  and  we  believe  that  we  are  in  substantial
compliance with the QSR. BSI, our European Notified Body, inspected our facility several times between 2010 and 2015 and found zero non-conformances. BSI
conducted four external audits in 2016 and zero non-conformances were found in all except for one audit, for which four minor non-conformances were found. Our
Notified  Body  audit  performed  in  January  2017  resulted  in  zero  non-conformances  and  an  unannounced  audit  in  September  2019,  noted  only  two  minor  non-
conformances, which were addressed promptly and resolved. In 2015, Avinger joined the medical device-single audit program (MDSAP) that permits audits by our
Notified Body to substitute for routine FDA inspections. As of the date of this filing, we have no outstanding unresolved major non-conformances or findings.

Failure to comply with applicable regulatory requirements can result in enforcement action by FDA, which may include any of the following sanctions:

•

•

•

•

•

•

warning letters, adverse publicity, fines, injunctions, consent decrees and civil penalties;

repair, replacement, refunds, recall or seizure of our products;

operating restrictions, partial suspension or total shutdown of production;

refusing our requests for 510(k) clearance or pre-market approval of new products, new intended uses or modifications to existing products;

withdrawing 510(k) clearance or pre-market approvals that have already been granted; and

criminal prosecution.

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Regulatory System for Medical Devices in Europe

The system of regulating medical devices operates by way of a certification for each medical device. Each certificated device is given CE marking that
shows the device has a Certificat de Conformité. There are national bodies known as Competent Authorities in each member state in the EU that oversee the
implementation of the EU’s medical device directive, or MDD, within its jurisdiction. The means of achieving the requirements for CE marking varies according to
the  nature  of  the  device.  Devices  are  classified  in  accordance  with  their  perceived  risks,  similarly  to  the  U.S.  system.  The  class  of  a  product  determines  the
requirements  to  be  fulfilled  before  CE  marking  can  be  placed  on  a  product,  known  as  a  conformity  assessment.  Currently  conformity  assessments  for  our
products are carried out as required by the MDD. Each member state can appoint Notified Bodies within its jurisdiction. If a Notified Body of one member state has
issued  a  Certificat  de  Conformité,  the  device  can  be  distributed  throughout  the  European  Union  without  further  conformance  tests  being  required  by  other
member states.

In  March  2019,  Avinger  successfully  transferred  all  current  product  certificates  from  BSI-UK  to  BSI-Netherlands  in  anticipation  of  the  UK  leaving  the
European Union. Our products currently with CE marking and distributed in the EU will be subject to the new EU medical device regulation, or MDR, (replacing
the  current  MDD)  starting  in  May  2021,  with  a  transitional  period  extending  to  May  26,  2024  or  the  length  of  the  currently  issued  Notified  Body  certification,
whichever comes first. We have multiple ongoing efforts to both extend the validity of our current MDD certificates and update our quality management system
and product technical documentation to be fully compliant with the MDR requirements. Until such time as we are fully certified to the new MDR, we will be highly
limited  in  our  ability  to  make  significant  product  changes  to  existing  design  and  intended  purposes  of  products  (for  distribution  in  the  EU  only)  and/or  will  be
unable to launch new products in the EU. Such limitations could harm our business, financial condition and operating results.

Federal, State and Foreign Fraud and Abuse Laws

Because of the significant federal funding involved in Medicare and Medicaid, Congress and the states have enacted, and actively enforce, a number of
laws to eliminate fraud and abuse in federal healthcare programs. Our business is subject to compliance with these laws. In March 2010, the Patient Protection
and Affordable Care Act, as amended by the Healthcare and Education Affordability Reconciliation Act, which we refer to collectively as the Affordable Care Act,
was enacted in the United States. The provisions of the Affordable Care Act are effective on various dates. The Affordable Care Act expands the government’s
investigative and enforcement authority and increases the penalties for fraud and abuse, including amendments to both the Anti-Kickback Statute and the False
Claims Act, to make it easier to bring suit under these statutes. The Affordable Care Act also allocates additional resources and tools for the government to police
healthcare fraud, with expanded subpoena power for HHS, additional funding to investigate fraud and abuse across the healthcare system and expanded use of
recovery audit contractors for enforcement.

Anti-Kickback  Statutes.        The  federal  Anti-Kickback  Statute  prohibits  persons  from  knowingly  and  willfully  soliciting,  offering,  receiving  or  providing
remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual, or the furnishing or arranging for a good or service, for which
payment  may  be  made  under  a  federal  healthcare  program  such  as  Medicare  or  Medicaid.  Violation  of  the  Anti-Kickback  Statue  is  a  criminal  felony,  and  can
result in criminal sanctions, civil penalties, enforcement under the False Claims Act, and exclusion from federal healthcare programs.

The definition of “remuneration” has been broadly interpreted to include anything of value, including, for example, gifts, certain discounts, the furnishing of
free  supplies,  equipment  or  services,  credit  arrangements,  payment  of  cash  and  waivers  of  payments.  Several  courts  have  interpreted  the  statute’s  intent
requirement to mean that if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare covered businesses, the statute
has  been  violated.  Penalties  for  violations  include  criminal  penalties  and  civil  sanctions  such  as  fines,  imprisonment  and  possible  exclusion  from  Medicare,
Medicaid and other federal healthcare programs. In addition, some kickback allegations have been claimed to violate the Federal False Claims Act, discussed in
more detail below.

The  Anti-Kickback  Statute  is  broad  and  prohibits  many  arrangements  and  practices  that  are  otherwise  lawful  in  businesses  outside  of  the  healthcare
industry. Recognizing that the Anti-Kickback Statute is broad and may technically prohibit many innocuous or beneficial arrangements, Congress authorized the
Office  of  Inspector  General,  or  OIG,  of  HHS  to  issue  a  series  of  regulations  known  as  “safe  harbors.”  These  safe  harbors  set  forth  provisions  that,  if  all  their
applicable requirements are met, will assure healthcare providers and other parties that they will not be prosecuted under the Anti-Kickback Statute. The failure of
a  transaction  or  arrangement  to  fit  precisely  within  one  or  more  safe  harbors  does  not  necessarily  mean  that  it  is  illegal  or  that  prosecution  will  be  pursued.
However,  conduct  and  business  arrangements  that  do  not  fully  satisfy  an  applicable  safe  harbor  may  result  in  increased  scrutiny  by  government  enforcement
authorities such as OIG.

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Many states have adopted laws similar to the Anti-Kickback Statute. Some of these state prohibitions apply to referral of recipients for healthcare items or

services reimbursed by any source, not only the Medicare and Medicaid programs.

Government officials have focused their enforcement efforts on the marketing of healthcare services and products, among other activities, and recently
have brought cases against companies, and certain individual sales, marketing and executive personnel, for allegedly offering unlawful inducements to potential
or existing customers in an attempt to procure their business.

Federal  False  Claims  Act.        Another  development  affecting  the  healthcare  industry  is  the  increased  use  of  the  federal  False  Claims  Act  by  federal
prosecutors, and in particular, action brought pursuant to the False Claims Act’s “whistleblower” or “qui tam” provisions. The False Claims Act imposes liability on
any person or entity that, among other things, knowingly presents, or causes to be presented, a false or fraudulent claim for payment by a federal healthcare
program. The qui tam provisions of the False Claims Act allow a private individual to bring actions on behalf of the federal government alleging that the defendant
has violated the False Claims Act and to share in any monetary recovery. In recent years, the number of suits brought against healthcare providers by private
individuals has increased substantially. In addition, various states have enacted false claims laws analogous to the False Claims Act, and many of these state
laws apply where a claim is submitted to any third-party payor and not just a federal healthcare program.

When an entity is determined to have violated the False Claims Act, it may be required to pay up to three times the actual damages sustained by the
government, plus civil penalties of between $11,665-$23,331 for each separate instance of false claim. As part of any settlement, the government may ask the
entity to enter into a corporate integrity agreement, which imposes certain compliance, certification and reporting obligations. There are many potential bases for
liability under the False Claims Act. Liability arises, primarily, when an entity knowingly submits, or causes another to submit, a false claim for reimbursement to
the federal government. The federal government has used the False Claims Act to assert liability on the basis of inadequate care, kickbacks and other improper
referrals, and improper use of Medicare numbers when detailing the provider of services, in addition to the more predictable allegations as to misrepresentations
with  respect  to  the  services  rendered.  In  addition,  the  federal  government  has  prosecuted  companies  under  the  False  Claims  Act  in  connection  with  off-label
promotion of products. Our future activities relating to the reporting of wholesale or estimated retail prices of our products, the reporting of discount and rebate
information and other information affecting federal, state and third-party reimbursement of our products and the sale and marketing of our products may be subject
to scrutiny under these laws.

While we are unaware of any current matters, we are unable to predict whether we will be subject to actions under the False Claims Act or a similar state
law,  or  the  impact  of  such  actions.  However,  the  costs  of  defending  such  claims,  as  well  as  any  sanctions  imposed,  could  significantly  affect  our  financial
performance.

The  Sunshine  Act.        The  Physician  Payment  Sunshine  Act,  or  the  Sunshine  Act,  which  was  enacted  as  part  of  the  Affordable  Care  Act,  requires  all
United States manufacturers of a prescription drug, device, biologic or other medical supply that has been approved or cleared by the FDA, and is available for
coverage by Medicare, Medicaid or the Children’s Health Insurance Program to report annually to the Secretary of HHS: (i) payments or other transfers of value
made  by  that  entity,  or  by  a  third-party  as  directed  by  that  entity,  to  physicians  and  teaching  hospitals  or  to  third  parties  on  behalf  of  physicians  or  teaching
hospitals; and (ii) physician ownership and investment interests in the drug and device manufacturing entity. The payments required to be reported include the
cost of meals provided to a physician, travel reimbursements and other transfers of value, including those provided as part of contracted services such as speaker
programs,  advisory  boards,  consultation  services  and  clinical  trial  services.  Failure  to  comply  with  the  reporting  requirements  can  result  in  significant  civil
monetary  penalties  ranging  from  $1,000  to  $10,000  for  each  payment  or  other  transfer  of  value  that  is  not  reported  (up  to  a  maximum  per  annual  report  of
$150,000) and from $10,000 to $100,000 for each knowing failure to report (up to a maximum per annual report of $1,150,000). Additionally, there are criminal
penalties  if  an  entity  intentionally  makes  false  statements  in  such  reports.  We  are  subject  to  the  Sunshine  Act  and  the  information  we  disclose  may  lead  to
greater  scrutiny,  which  may  result  in  modifications  to  established  practices  and  additional  costs.  Additionally,  similar  reporting  requirements  have  also  been
enacted  on  the  state  level  domestically,  and  an  increasing  number  of  countries  worldwide  either  have  adopted  or  are  considering  similar  laws  requiring
transparency of interactions with healthcare professionals.

Foreign Corrupt Practices Act.    The Foreign Corrupt Practices Act, or FCPA, prohibits any United States individual or business from paying, offering, or
authorizing payment or offering of anything of value, directly or indirectly, to any foreign official, political party or candidate for the purpose of influencing any act
or  decision  of  the  foreign  entity  in  order  to  assist  the  individual  or  business  in  obtaining  or  retaining  business.  The  FCPA  also  obligates  companies  whose
securities  are  listed  in  the  United  States  to  comply  with  accounting  provisions  requiring  us  to  maintain  books  and  records  that  accurately  and  fairly  reflect  all
transactions  of  the  corporation,  including  international  subsidiaries,  if  any,  and  to  devise  and  maintain  an  adequate  system  of  internal  accounting  controls  for
international operations.

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International Laws.    In Europe, various countries have adopted anti-bribery laws providing for severe consequences, in the form of criminal penalties
and/or significant fines, for individuals and/or companies committing a bribery offense. Violations of these anti-bribery laws, or allegations of such violations, could
have a negative impact on our business, results of operations and reputation. For instance, in the United Kingdom, under the Bribery Act 2010, which went into
effect  in  July  2011,  a  bribery  occurs  when  a  person  offers,  gives  or  promises  to  give  a  financial  or  other  advantage  to  induce  or  reward  another  individual  to
improperly  perform  certain  functions  or  activities,  including  any  function  of  a  public  nature.  Bribery  of  foreign  public  officials  also  falls  within  the  scope  of  the
Bribery  Act  2010.  Under  the  new  regime,  an  individual  found  in  violation  of  the  Bribery  Act  of  2010,  faces  imprisonment  of  up  to  10  years.  In  addition,  the
individual can be subject to an unlimited fine, as can commercial organizations for failure to prevent bribery.

There are also international privacy laws that impose restrictions on the access, use, and disclosure of health information. All of these laws may impact
our business. Our failure to comply with these privacy laws or significant changes in the laws restricting our ability to obtain required patient information could
significantly impact our business and our future business plans.

U.S. Healthcare Reform

Changes in healthcare policy could increase our costs and subject us to additional regulatory requirements that may interrupt commercialization of our
current  and  future  solutions.  Changes  in  healthcare  policy  could  increase  our  costs,  decrease  our  revenues  and  impact  sales  of  and  reimbursement  for  our
current  and  future  solutions.  The  Affordable  Care  Act  substantially  changes  the  way  healthcare  is  financed  by  both  governmental  and  private  insurers,  and
significantly impacts our industry principally by moving healthcare reimbursement towards more value-based and quality-based payment methodologies. The Act
contains  a  number  of  provisions  that  impact  our  business  and  operations,  some  of  which  in  ways  we  cannot  currently  predict,  including  those  governing
enrollment in federal healthcare programs and reimbursement changes.

There will continue to be proposals by legislators at both the federal and state levels, regulators and third-party payors to reduce costs while expanding
individual  healthcare  benefits.  Certain  of  these  changes  could  impose  additional  limitations  on  the  prices  we  will  be  able  to  charge  for  our  current  and  future
solutions  or  the  amounts  of  reimbursement  available  for  our  current  and  future  solutions  from  governmental  agencies  or  third-party  payors.  Furthermore,  the
current presidential administration and Congress may again attempt broad sweeping changes to the current healthcare laws. We face uncertainties that might
result from modification or repeal of any of the provisions of the Affordable Care Act, including as a result of current and future executive orders and legislative
actions.  The  impact  of  those  changes  on  us  and  potential  effect  on  the  medical  device  industry  as  a  whole  is  currently  unknown.  But,  any  changes  to  the
Affordable Care Act are likely to have an impact on our results of operations, and may have a material adverse effect on our results of operations. We cannot
predict what other healthcare programs and regulations will ultimately be implemented at the federal or state level or the effect any future legislation or regulation
in the United States may have on our business.

Third-Party Reimbursement

Payment for patient care in the United States is generally made by third-party payors, including private insurers and government insurance programs,
such  as  Medicare  and  Medicaid.  The  Medicare  program,  the  largest  single  payor  in  the  United  States,  is  a  federal  governmental  health  insurance  program
administered by the Centers for Medicare and Medicaid Services, or CMS, and covers certain medical care expenses for eligible elderly and disabled individuals.
Because a large percentage of the population with PAD includes Medicare beneficiaries, and private insurers may follow the coverage and payment policies of
Medicare, Medicare’s coverage and payment policies are significant to our operations.

Medicare  pays  PAD  treatment  facilities,  including  hospitals  and  physician  office-based  labs,  pre-determined  amounts  for  each  procedure  performed.

These payment amounts differ based on a variety of factors, including:

•

•

•

•

Type of procedure performed—angioplasty, stent or atherectomy;

Patient-specific complexities and comorbidities;

Type of facility—hospital, teaching hospital or office-based lab;

Inpatient or outpatient status; and

• Geographic region.

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We receive payment from the treatment facility for our products, and the Medicare reimbursement to the facility is intended to cover the overall cost of
treatment, including the cost of products used during the procedure as well as the overhead cost associated with the facility where the procedure is performed.
For procedures performed in hospitals, the physician who performs the procedure is reimbursed separately under the Medicare physician fee schedule. Claims
for  PAD  procedures  are  typically  submitted  by  the  treatment  facility  and  physician  to  Medicare  or  other  health  insurers  using  established  billing  codes.  These
codes identify the procedures performed and are relied upon to determine third-party payor reimbursement amounts.

Medicare reimbursement for hospital outpatient PAD procedures that include atherectomy for 2020 ranged between approximately $10,000 and $16,000.
These amounts include the cost of disposable catheters such as Ocelot and Pantheris. While reimbursement varies based on the type of procedure performed
(e.g.,  angioplasty,  stent  or  atherectomy),  additional  device-specific  reimbursement  is  not  available.  The  amount  of  reimbursement  can  vary  substantially  by
geographical  region  and  by  facility.  Payment  rates  of  other  third-party  payors  may  follow  Medicare  rates,  or  they  may  be  higher  or  lower,  depending  on  their
particular reimbursement methodology. Because of the wide variability, it is not possible to identify an average rate for third-party payors other than Medicare.

Human Capital

As  of  December  31,  2020,  we  had  75  employees,  including  22  in  manufacturing  and  operations,  30  in  sales  and  marketing,  5  in  research  and
development  and  clinical  and  regulatory  affairs,  6  in  quality  assurance  and  12  in  finance,  general  administrative  and  executive  administration.  Of  these  75
employees, 6 are part time employees.

None of our employees are represented by a labor union or covered by a collective bargaining agreement. We have never experienced any employment-

related work stoppages and we consider our employee relations to be good.

Although the COVID-19 pandemic has disrupted business and operations for companies around the globe, the resilience of our employees has enabled
us to minimize disruption to our sales, research, clinical studies and operations. Our onsite employees, particularly in manufacturing and operations, have rapidly
adjusted to numerous stringent safety protocols. A number of our other employees have shifted to work-from-home status since March 2020.

We are optimistic about the potential to expand our workforce and create a more inclusive environment for all of our employees.

Diversity, Equity and Inclusion

We  understand  the  importance  of  diversity  in  our  workforce.  We  will  continue  to  focus  on  building  a  pipeline  of  opportunities  for  both  the  hiring  and
advancement of qualified individuals, including for women, persons with disabilities, and minority groups that are underrepresented in science and engineering
industries. We believe that diverse perspectives will help empower our employees, patients and industry.

Communications and Engagement

Our  success  depends  on  employees  understanding  our  strategic  vision  as  well  as  our  day-to-day  objectives.  To  that  end,  we  employ  a  mix  of
communication and engagement channels, including all-hands meetings, regular leadership meetings, and quarterly updates on our progress against our strategic
goals. We have also created a cross-functional team focused on improving the employee experience and driving engagement.

A central part of our communications and engagement efforts are connecting people to purpose. To this end, we regularly share stories of physicians and
patients  that  have  been  treated  with  our  devices  with  our  employees.  Their  experiences  reinforce  our  commitment  to  expand  our  reach  into  new  patient
populations, geographies and markets.

Health, Safety and Wellness

We  are  deeply  committed  to  the  safety,  health  and  wellness  of  our  employees.  The  Avinger  Environmental,  Health  &  Safety  team  develops  safety
practices and procedures, trains employees, and monitors compliance. Through these efforts, along with leadership commitment and investment of resources in
support of workplace safety initiatives, our total US injury rate has consistently tracked below industry averages.

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Compensation

We  recognize  that  our  employees  are  our  most  valuable  asset.  Our  total  rewards  package  includes  market  competitive  pay,  comprehensive  and
competitive  benefits  and  retirement  offerings  and  paid  time  off  and  family  leave,  among  other  benefits.  To  foster  a  stronger  sense  of  ownership  and  align  the
interests of employees with shareholders, we have offered restricted stock units to eligible employees under our broad-based stock incentive programs.

Corporate and other Information

We  were  incorporated  in  Delaware  on  March  8,  2007.  Our  principal  executive  offices  are  located  at  400  Chesapeake  Drive,  Redwood  City,  California
94063,  and  our  telephone  number  is  (650)  241-7900.  Our  website  address  is  www.avinger.com.  References  to  our  website  address  do  not  constitute
incorporation by reference of the information contained on the website, and the information contained on the website is not part of this document.

We  make  available,  free  of  charge  on  our  corporate  website,  copies  of  our  Annual  Reports  on  Form  10-K,  Quarterly  Reports  on  Form  10-Q,  Current
Reports on Form 8-K, Proxy Statements, and all amendments to these reports, as soon as reasonably practicable after such material is electronically filed with or
furnished to the Securities and Exchange Commission, or the SEC, pursuant to Section 13(a) or 15(d) of the Securities Exchange Act. We also show detail about
stock trading by corporate insiders by providing access to SEC Forms 3, 4 and 5. This information may also be obtained from the SEC’s on-line database, which
is located at www.sec.gov. Our common stock is traded on the Nasdaq Capital Market under the symbol “AVGR”.

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Item 1A.    Risk Factors

Investing in our common stock involves a high degree of risk. We have identified the following risks and uncertainties that may have a material adverse
effect on our business, financial condition, results of operations and future growth prospects. Our business could be harmed by any of these risks. The risks and
uncertainties described below are not the only ones we face. If any of the risks actually occur, our business, financial condition, results of operations, cash flows
and prospects could be materially and adversely affected. The trading price of our common stock could decline due to any of these risks, and you may lose all or
part  of  your  investment.  In  assessing  these  risks,  you  should  also  refer  to  the  other  information  contained  in  this  Annual  Report  on  Form  10-K,  including  our
financial statements and related notes. Please also see “Cautionary Notes Regarding Forward-Looking Statements.”

Risk Factor Summary         

The  risk  factors  summarized  and  detailed  below  could  materially  harm  our  business,  operating  results  and/or  financial  condition,  impair  our  future
prospects and/or cause the price of our common stock to decline. These are not all of the risks we face and other factors not presently known to us or that we
currently believe are immaterial may also affect our business if they occur. Material risks that may affect our business, operating results and financial condition
include, but are not necessarily limited to, those relating to:

Risks Related to Our Business

•

•

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•

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significant fluctuations in our operating results;

our history of net losses and ability to achieve profitability;

our ability to obtain additional capital on acceptable terms or at all;

our significant levels of debt;

our covenants and restrictions under our Loan Agreement with CRG;

our ability to generate sufficient cash to service our Loan Agreement with CRG;

our reliance on a limited number of products with a limited commercial history;

our reliance on sales professionals to market and sell our products;

our ability to demonstrate the benefits of our Lumivascular platform to physicians, hospitals, and patients and our ability to innovate successfully;

our dependence on working relationships with physicians;

our competition, which includes companies that have longer operating histories, more established products, and greater resources;

the potential for disruptions at our manufacturing facility;

our dependence on third-party vendors, including some single-source suppliers, to manufacture some of our components, coating, and sub-assemblies;

our dependence on our senior management team and key employees;

our intention not to devote significant resources in the near-term to market our Lumivascular platform internationally;

our ability to use our net operating loss carryforwards;

the possibility that we may acquire other companies or technologies, or be the target of strategic transactions;

the ongoing COVID-19 pandemic and responses thereto, and its effect on customer demand;

our ability to receive forgiveness of our recently received PPP Loan;

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Risks Related to Our Use of Technology and Intellectual Property

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our technology infrastructure and the potential of a cybersecurity incident or data breach;

any future intellectual property litigation or administrative proceedings;

certain patents held by third parties that may be asserted against us in litigation;

any failure to adequately protect our intellection property rights;

Regulatory and Litigation Risks

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compliance with applicable laws and regulations;

obtaining or maintaining necessary regulatory clearances of approvals;

any material modifications to our Lumivascular platform products, which may require new clearances or approvals;

certain limitations on our ability to market our current products in the United States;

the success and timing of our clinical trials;

the performance of the outside parties that we engage to perform services related to certain of our clinical studies;

our limited long-term data regarding the safety and efficacy of our Lumivascular platform products;

our suppliers’ compliance with the FDA’s QSR;

any product recalls on our Lumivascular products;

any changes in coverage and reimbursement for procedures using our Lumivascular products;

any healthcare reform measures;

compliance with healthcare regulations;

compliance with environmental laws and regulations;

regulations related to “conflict minerals”;

any use, misuse, or off-label use of our products;

the expense and availability of insurance coverage for liabilities resulting from our products;

Risks Related to Our Organizational Structure

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the volatility of our stock price;

our ability to meet guidance or expectations;

coverage or lack of coverage of our business by securities or industry analysts;

any sales of substantial numbers of shares of our common stock in the public market;

the requirements and expense of being a public company;

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•

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the possibility that Nasdaq may delist our securities from its exchange;

anti-takeover provisions in our amended and restated certificate of incorporation, bylaws, and Delaware law;

the forum selection clause in our amended and restated certificate of incorporation;

our anticipation that we will not pay cash dividends in the foreseeable future;

CRG’s ability to exert significant control over certain matters pursuant to our loan agreement;

the liquidation preference of our Series A preferred stock, and;

the current number of authorized shares available for issuance.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Risks Related to Our Business

Our  quarterly  and  annual  results  may  fluctuate  significantly,  may  not  fully  reflect  the  underlying  performance  of  our  business  and  may  result  in
decreases in the price of our common stock.

Our quarterly and annual results of operations, including our revenues, profitability and cash flow, may vary significantly in the future and period-to-period
comparisons of our operating results may not be meaningful. Accordingly, the results of any one quarter or period should not be relied upon as an indication of
future performance. Our quarterly and annual financial results may fluctuate as a result of a variety of factors, many of which are outside our control and, as a
result, may not fully reflect the underlying performance of our business. Fluctuation in quarterly and annual results may decrease the value of our common stock.
Factors that may cause fluctuations in our quarterly and annual results include, without limitation:

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our ability to obtain and maintain FDA clearance and approval from foreign regulatory authorities for our products, and the timing of such clearances and
approvals, particularly with respect to current and future generations of Pantheris and Ocelot product families;

• market acceptance of our Lumivascular platform and products, including Pantheris and Ocelot;

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the availability of reimbursement for our Lumivascular platform products;

our ability to attract new customers and increase the amount of business we generate from existing customers;

results of our clinical trials;

the timing and success of new product and feature introductions by us or our competitors or any other change in the competitive dynamics of our industry,
including consolidation among competitors, customers or strategic partners;

the amount and timing of costs and expenses related to the maintenance and expansion of our business and operations;

changes in our pricing policies or those of our competitors;

general economic, political, industry and market conditions;

the regulatory environment;

the hiring, training and retention of key employees, including our sales team;

the cost and potential outcomes of any litigation;

our ability to obtain additional financing; and

advances and trends in new technologies and industry standards.

We have a history of net losses and we may not be able to achieve or sustain profitability.

We have incurred significant losses in each period since our inception in 2007. We incurred net losses of $19.0 million in 2020 and $19.5 million in 2019.
As  of  December  31,  2020,  we  had  an  accumulated  deficit  of  approximately  $367.3  million.  These  losses  and  our  accumulated  deficit  reflect  the  substantial
investments we have made to develop our Lumivascular platform and acquire customers.

We expect our losses to continue for the foreseeable future as we continue to make significant future expenditures to develop and expand our business.
In  addition,  as  a  public  company,  we  will  continue  to  incur  significant  legal,  accounting  and  other  expenses.  Accordingly,  we  cannot  assure  you  that  we  will
achieve profitability in the future or that, if we do become profitable, we will sustain profitability. Our failure to achieve and sustain profitability would negatively
impact the market price of our common stock.

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We may not be able to secure additional financing on favorable terms, or at all, to meet our future capital needs and our failure to obtain additional
financing when needed could force us to delay, reduce or eliminate our product development programs and commercialization efforts or cause us to
become insolvent.

We believe that our cash and cash equivalents at December 31, 2020, together with debt and financing activities and expected revenues from operations,
will be sufficient to satisfy our capital requirements and fund our operations through 2022. Even though we received net proceeds of approximately $8.0 million
from the issuance of common stock upon the exercise of warrants during March and April of 2019, net proceeds of $3.8 million from the sales of our common
stock  in  our  August  2019  offering,  $3.9  million  from  the  sale  of  our  common  stock  in  our  January  2020  offering,  $2.3  million  of  loan  proceeds  in  April  2020
pursuant to the Paycheck Protection Program (“PPP”) under the Coronavirus Aid, Relief and Economic Security (“CARES”) Act, $3.0 million from the sale of our
common stock in April and May 2020, $5.5 million from the sale of our common stock in June and July 2020 $11.3 million from the sale of our common stock in
August  and  September  2020,  and  approximately  $13.0  million  from  the  sale  of  our  common  stock  in  February  2021,  we  may  need  to  raise  additional  funds
through  future  equity  or  debt  financings  in  the  near  future  to  meet  our  operational  needs  and  capital  requirements  for  product  development,  clinical  trials  and
commercialization. We can provide no assurance that we will be successful in raising funds pursuant to additional equity or debt financings or that such funds will
be raised at prices that do not create substantial dilution for our existing stockholders. Given the volatility of our stock price, any financing that we undertake could
cause substantial dilution to our existing stockholders.

To date, we have financed our operations primarily through sales of our products and net proceeds from the issuance of our preferred stock and debt
financings, our initial public offering, or IPO, and our follow-on public offerings. We do not know when or if our operations will generate sufficient cash to fund our
ongoing  operations.  We  cannot  be  certain  that  additional  capital  will  be  available  as  needed  on  acceptable  terms,  or  at  all.  In  the  future,  we  may  require
additional capital in order to (i) continue to conduct research and development activities, (ii) conduct post-market clinical studies, as well as clinical trials to obtain
regulatory  clearances  and  approvals  necessary  to  commercialize  our  Lumivascular  platform  products,  (iii)  expand  our  sales  and  marketing  infrastructure,  (iv)
acquire  complementary  businesses  technologies  or  products;  or  (v)  respond  to  business  opportunities,  challenges,  a  decline  in  sales,  increased  regulatory
obligations or unforeseen circumstances. Our future capital requirements will depend on many factors, including:

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the  degree  of  success  we  experience  in  commercializing  our  Lumivascular  platform  products,  particularly  Pantheris,  and  any  future  versions  of  such
products;

the costs, timing and outcomes of clinical trials and regulatory reviews associated with our future products;

the costs and expenses of maintaining or expanding our sales and marketing infrastructure and our manufacturing operations;

the costs and timing of developing variations of our Lumivascular platform products and, if necessary, obtaining FDA clearance of such variations;

the  extent  to  which  our  Lumivascular  platform  is  adopted  by  hospitals  for  use  by  interventional  cardiologists,  vascular  surgeons  and  interventional
radiologists in the treatment of PAD;

the number and types of future products we develop and commercialize;

the costs of defending ourselves against future litigation;

the costs of preparing, filing and prosecuting patent applications and maintaining, enforcing and defending intellectual property-related claims; and

the extent and scope of our general and administrative expenses.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We may raise additional funds in equity or debt financings or enter into credit facilities in order to access funds for our capital needs. Any debt financing
obtained  by  us  in  the  future  would  cause  us  to  incur  additional  debt  service  expenses  and  could  include  restrictive  covenants  relating  to  our  capital  raising
activities and other financial and operational matters, which may make it more difficult for us to obtain additional capital and pursue business opportunities. In
addition, due to our current level of debt, future equity investors may require that we convert all or a portion of our debt to equity, and our debtholders may not
agree  to  such  terms.  If  we  raise  additional  funds  through  further  issuances  of  equity  or  convertible  debt  securities,  and/or  if  we  convert  all  or  a  portion  of  our
existing debt to equity, our existing stockholders could suffer significant dilution in their percentage ownership of our company, and any new equity securities we
issue could have rights, preferences and privileges senior to those of holders of our common stock. If we are unable to obtain adequate financing or financing on
terms satisfactory to us when we require it, we may terminate or delay the development of one or more of our products, delay clinical trials necessary to market
our products, delay establishment of sales and marketing capabilities or other activities necessary to commercialize our products, and significantly scale back our
operations, or we may become insolvent. If this were to occur, our ability to continue to grow and support our business and to respond to business challenges
could be significantly limited.

We  have  a  significant  amount  of  debt,  which  may  adversely  affect  our  ability  to  operate  our  business  and  our  financial  position  and  our  ability  to
secure additional financing in the future.

As  of  December  31,  2020,  we  had  $11.1  million  in  principal,  back-end  fees  and  interest  outstanding  under  a  Term  Loan  Agreement,  or  the  Loan

Agreement, with CRG Partners III L.P. and certain of its affiliated funds (collectively “CRG”). Our significant amount of debt may:

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increase our vulnerability to adverse changes in general economic, industry and competitive conditions;

require us to dedicate a substantial portion of our cash flow from operations to make payments on our debt, thereby reducing the availability of our cash
flow to fund working capital, capital expenditures and other general corporate purposes;

limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate;

restrict us from exploiting business opportunities;

• make it more difficult to satisfy our financial obligations, including payments on the Loan Agreement;

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place us at a competitive disadvantage compared to our competitors that have less debt obligations; and

limit  our  ability  to  borrow  additional  funds  for  working  capital,  capital  expenditures,  acquisitions,  debt  service  requirements,  execution  of  our  business
strategy or other general corporate purposes on satisfactory terms or at all.

The  existence  of  a  substantial  amount  of  debt  may  make  it  difficult  for  us  to  run  our  business  effectively  or  raise  the  capital  we  need  to  continue  our

operations.

Covenants under the Loan Agreement will restrict our business in many ways.

The Loan Agreement contains various covenants that limit, subject to certain exceptions, our ability to, among other things:

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incur or assume liens;

incur additional debt or provide guarantees in respect of obligations of other persons;

issue redeemable stock and preferred stock;

pay  dividends  or  make  distributions  on  capital  stock,  repurchase,  redeem  or  make  payments  on  capital  stock  or  repay,  repurchase,  redeem,  retire,
defease, acquire or cancel debt prior to the stated maturity thereof;

• make loans, investments or acquisitions;

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create or permit restrictions on the ability of our subsidiaries to pay dividends or make other distributions to us or to guarantee our debt, limit our or any of
our subsidiaries ability to create liens, or make or pay intercompany loans or advances;

enter into certain transactions with affiliates;

sell, transfer, license, lease or dispose of our or our subsidiaries’ assets, including the capital stock of our subsidiaries; and

dissolve, liquidate, consolidate or merge with or into, or sell substantially all of our assets to another person.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In particular, the Loan Agreement, as amended in January 2021, includes a covenant that we maintain a minimum of $3.5 million of cash and certain cash
equivalents, and we will have to achieve minimum revenues of $8.0 million in 2021, $10.0 million in 2022, $12.0 million in 2023, $14.5 million in 2024 and $17.0
million in 2025. If we fail to meet the applicable minimum revenue target in any calendar year, the Loan Agreement provides a cure right if we prepay a portion of
the  outstanding  principal  equal  to  2.0  times  the  revenue  shortfall.  There  can  be  no  assurance  as  to  our  future  compliance  with  the  covenants  under  the  Loan
Agreement, as amended.

The covenants contained in the Loan Agreement could adversely affect our ability to execute our business strategies by restricting our ability to make
capital  expenditures,  engage  in  strategic  acquisitions,  refinance  our  outstanding  indebtedness,  or  obtain  additional  financing.  Such  restrictions  may  make  it
difficult to plan for or react to changes in market conditions, such as future downturns in our business or the economy in general.

In addition, potential sources of equity financing may decline to invest in our company given the amount of debt and the rights that debt holders have to
get paid before equity holders. In order to facilitate equity investments, future equity investors may require that we convert all or a portion of our debt to equity,
and our debtholders may not agree to such terms. The amount of debt could therefore affect our ability to finance our company and prevent us from obtaining
necessary operating capital as a result.

We  may  not  be  able  to  generate  sufficient  cash  to  service  our  Loan  Agreement.  If  we  default  on  payments  or  otherwise  fail  to  comply  with  our
obligations  under  our  Loan  Agreement,  the  lender  may  be  able  to  accelerate  amounts  owed  under  the  facility  and  may  foreclose  upon  the  assets
securing our obligations.

Borrowings under our Loan Agreement are secured by substantially all of our personal property, including our intellectual property. The existing collateral
pledged  under  the  Loan  Agreement  may  prevent  us  from  being  able  to  secure  additional  debt  or  equity  financing  on  favorable  terms,  or  at  all,  or  to  pursue
business  opportunities,  including  potential  acquisitions.  Our  ability  to  make  scheduled  payments,  comply  with  our  debt  covenants,  or  to  refinance  our  debt
obligations depends on numerous factors, including the amount of our cash reserves and our actual and projected financial and operating performance. These
amounts and our performance are subject to numerous risks, including the risks in this section, some of which may be beyond our control. We cannot assure you
that we will maintain a level of cash reserves or cash flows from operating activities sufficient to permit us to pay the principal, premium, if any, and interest on our
existing or future indebtedness. If our cash flows and capital resources are insufficient to fund our debt service obligations, we may be forced to reduce or delay
capital expenditures, sell assets or operations, seek additional capital or restructure or refinance our indebtedness. We cannot assure you that we would be able
to take any of these actions, or that these actions would permit us to meet our scheduled debt service obligations. In addition, in the event of our breach of the
Loan  Agreement,  we  may  be  required  to  repay  any  outstanding  amounts  earlier  than  anticipated.  If  we  fail  to  comply  with  our  obligations  under  the  Loan
Agreement, the lender would be able to accelerate the required repayment of amounts due and, if they are not repaid, could foreclose upon our assets securing
our obligations under the Loan Agreement.

Our  success  depends  in  large  part  on  a  limited  number  of  products,  particularly  Pantheris  product  family,  all  of  which  have  a  limited  commercial
history. If these products fail to gain, or lose, market acceptance, our business will suffer.

Ocelot, Ocelot PIXL, Ocelot MVRX, Tigereye, Lightbox, Wildcat, Kittycat 2, Pantheris and Pantheris SV are our only products currently cleared for sale,
and  our  current  revenues  are  wholly  dependent  on  them.  Sales  of  Wildcat  and  Kittycat  2  have  declined  and  are  continuing  to  decline  as  we  focus  on  the
promotion of our Lumivascular platform products. In addition, the long-term viability of our company is largely dependent on the successful commercialization and
continued  development  of  the  Pantheris  product  family  and  we  expect  that  sales  of  our  other  current  and  future  Lumivascular  platform  products  in  the  United
States will account for substantially all of our revenues for the foreseeable future. Accordingly, our success depends on the continued and growing acceptance
and use of Lumivascular platform products by the medical community.

All  of  our  products  have  a  limited  commercial  history.  For  example,  we  received  510(k)  clearance  from  the  FDA  to  commercialize  Pantheris  in
October  2015  as  well  as  a  separate  FDA  clearance  to  market  enhanced  versions  of  Pantheris  in  March  2016  and  May  2018  and  those  versions  of  Pantheris
became  commercially  available  in  the  United  States  and  select  international  markets  promptly  thereafter.  Pantheris  SV  launched  in  July  2019  after  having
received  FDA  clearance  in  April  2019.  Tigereye  launched  in  October  2020  after  having  received  FDA  clearance  in  September  2020.  Our  limited
commercialization  experience  and  number  of  approved  products  make  it  difficult  to  evaluate  our  current  business  and  predict  our  future  prospects.  We  have
encountered and will continue to encounter risks and difficulties frequently experienced by companies in rapidly-changing industries.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
Our ability to successfully market Lumivascular platform products will also be limited due to a number of factors including regulatory restrictions in our
labeling.  We  cannot  assure  demand  for  Lumivascular  platform  products  will  continue  to  grow  or  that  our  products  will  significantly  penetrate  current  or  new
markets.  Market  demand  for  our  Lumivascular  platform  products  and  physician  adoption  of  these  products  also  may  be  negatively  impacted  by  product
performance issues and the need to replace certain products in accordance with our warranty policy. Utilization of our products has been less than we anticipated
historically. If demand for our Lumivascular platform products does not increase and we cannot sell our products as planned, our financial results will be harmed.
In  addition,  market  acceptance  may  be  hindered  if  physicians  are  not  presented  with  compelling  data  from  long-term  studies  of  the  safety  and  efficacy  of  our
Lumivascular  platform  products  compared  to  alternative  procedures,  such  as  angioplasty,  stenting,  bypass  surgery  or  other  atherectomy  procedures.  For
example, if patients undergoing treatment with our Lumivascular platform products have retreatment rates higher than or comparable with the retreatment rates
of  alternative  procedures,  it  will  be  difficult  to  demonstrate  the  value  of  our  Lumivascular  platform  products.  Any  studies  we  may  conduct  comparing  our
Lumivascular platform with alternative procedures will be expensive, time consuming and may not yield positive results. Physicians will also need to appreciate
the  value  of  real-time  imaging  in  improving  patient  outcomes  in  order  to  change  current  methods  for  treating  PAD  patients.  In  addition,  demand  for  our
Lumivascular platform products may decline or may not increase as quickly as we expect. Failure of our Lumivascular platform products to significantly penetrate
current or new markets, or our failure to successfully commercialize our products, would harm our business, financial condition and results of operations.

We are also aware of certain characteristics and features of our Lumivascular platform that may prevent widespread market adoption. For example, in
procedures  using  the  current  model  of  Pantheris,  some  physicians  may  prefer  to  have  a  technician  or  second  physician  assisting  with  the  operation  of  the
catheter as well as a separate technician to operate the Lightbox, potentially making it less financially attractive for physicians and their hospitals and medical
facilities.  It  may  take  significant  time  and  expense  to  modify  our  products  to  allow  a  single  physician  to  operate  the  entire  system  and  we  can  provide  no
guarantee that we will be able to make such modifications or obtain any additional and necessary regulatory clearances for such modifications. Although the OCT
images  created  by  our  Lightbox  may  make  it  possible  for  physicians  to  reduce  the  degree  to  which  fluoroscopy  and  contrast  dye  are  used  when  using  our
Lumivascular platform products compared to competing endovascular products, physicians are still using both fluoroscopy and contrast dye in these procedures.
As  a  result,  risks  of  complications  from  radiation  and  contrast  dye  are  still  present  and  may  limit  the  commercial  success  of  our  products.  Finally,  it  requires
training of technicians and physicians to effectively operate our Lumivascular platform products, including interpreting the OCT images created by our Lightbox,
which may affect adoption of our products by physicians.

Our  Lumivascular  products  are  highly  complex  and  the  failure  of  relatively  minor  components  could  result  in  product  failure  or  other  significant
performance issues that may not be discovered until after delivery to customers, which could give rise to claims from our customers or their patients. We have in
the  past,  and  may  in  the  future,  become  aware  of  performance  issues  with  our  products.  For  example,  prior  to  becoming  commercially  available  on  March  1,
2016, Pantheris had been used in clinical trials mainly in controlled situations. Since its commercialization and as more physicians have used Pantheris, we have
received additional feedback on its performance, both positive and negative. We have attempted to address certain of these concerns with our current version of
Pantheris. However, there can be no assurance that the changes and improvements will fully address the performance issues that have been raised by earlier
versions  of  Pantheris.  Our  revenue  has  been  adversely  impacted  by  these  product  performance  issues.  We  also  had  to  incur  additional  expenses  to  make
product changes and improvements, and to replace products in accordance with our warranty policy. If future product performance issues are not resolved and
physician concerns not addressed, our reputation could suffer, which could lead to decreased sales of our products.

We rely heavily on our sales professionals to market and sell our products. If we are unable to hire, effectively train, manage, improve the productivity
of, and retain our sales professionals, our business will be harmed, which would impair our future revenue and profitability.

Our success largely depends on our ability to hire, train, manage and improve the productivity levels of our sales professionals. We have experienced
turnover of our sales professionals in the past. The loss of any member of our sales team’s senior management could weaken our sales expertise and harm our
business, and we may not be able to find adequate replacements on a timely basis, or at all. The changes in senior management that have occurred over the
past several years may continue to create instability in our sales force leading to attrition in sales representatives in the future.

Competition for sales professionals who are familiar with and trained to sell our products continues to be strong. We train our sales professionals to better
understand  our  existing  and  new  product  technologies  and  how  they  can  be  positioned  against  our  competitors’  products.  These  initiatives  are  intended  to
improve the productivity of our sales professionals and our revenue and profitability. It takes time for the sales professionals to become productive following their
hiring and training and there can be no assurance that sales representatives will reach adequate levels of productivity, or that we will not experience significant
levels of attrition in the future. Measures we implement to improve the productivity may not be successful and may instead cause additional departures from our
sales organization, or further reduce our revenue, profitability, and harm our business and our stock price may be adversely impacted as a result. 

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Our ability to compete is highly dependent on demonstrating the benefits of our Lumivascular platform to physicians, hospitals and patients and our
ability to innovate new and improved products.

In  order  to  generate  sales,  we  must  be  able  to  clearly  demonstrate  that  our  Lumivascular  platform  is  a  more  effective  treatment  system  than  the
alternatives offered by our competitors. If we are unable to convince physicians that our Lumivascular platform leads to significantly lower rates of restenosis, or
narrowing of the artery, and leads to fewer adverse events during treatment than those using competing technologies, our business will suffer. We must convince
hospitals and physicians that our Lumivascular platform results in significantly better patient outcomes at a competitive overall cost. For example, we may need to
demonstrate that the investment hospitals must make if purchasing our Lightbox and the incremental costs of having a technician or a second individual operate
Pantheris can be justified based on the benefits to patients, physicians and hospitals. If we are unable to develop robust clinical data to support these claims, we
will be unable to convince hospitals and third-party payors of these benefits and our business will suffer.

Our value proposition to physicians and hospitals is largely dependent upon our contention that the rate of arterial damage when physicians are using our
imaging  products  is  lower  than  with  non-imaging  competing  products.  If  minimizing  arterial  damage  does  not  significantly  impact  patient  outcomes,  meaning
either  (i)  that  restenosis  is  often  triggered  without  disrupting  healthy  arterial  structures  or  (ii)  arteries  can  be  damaged  during  treatment  without  triggering
restenosis, then we may be unable to demonstrate our Lumivascular platform’s benefits are any different than competing technologies. Furthermore, physicians
may  find  our  imaging  system  difficult  to  use,  and  we  may  not  be  able  to  provide  physicians  with  adequate  training  to  be  able  to  realize  the  benefits  of  our
Lumivascular  platform.  If  physicians  do  not  value  the  benefits  of  on-board  imaging  and  the  enhanced  visualization  enabled  by  our  products  during  an
endovascular intervention as compared to our competitors’ products, or do not believe that such benefits improve clinical outcomes, our Lumivascular platform
products may not be widely adopted.

In  order  to  remain  competitive,  we  must  also  continue  to  develop  new  product  offerings  and  enhancements  to  our  existing  Lumivascular  platform
products. The market for medical devices in general, and in the PAD market in particular, is highly competitive, dynamic, and marked by rapid and substantial
technological development and product innovation. If we are unable to innovate successfully, our Lumivascular platform products could become obsolete and our
revenues would decline as our customers purchase our competitors’ products. In addition, our innovation efforts may not result in new products that generate
additional revenue. For example, we believe that our next-generation Pantheris and Pantheris SV are important to our future revenues, and we are devoting a
significant portion of our resources to their continued development. However, we do not yet know whether these or any other new offerings will be well received
and broadly accepted by physicians, and if so, whether sales will be sufficient for us to offset costs of development, implementation, support, operation, sales and
marketing. Additionally, new products may subject us to additional risks of product performance, market adoption, customer complaints and litigation. If sales of
our  new  product  offerings,  including  are  lower  than  we  expect,  fail  to  gain  anticipated  market  acceptance  or  cause  us  to  expend  additional  resources  to  fix
unforeseen problems and develop modifications, our revenues and results of operations may not improve and our business will be adversely affected.

Our ability to develop, market, and sell our products depends in part upon our working relationships with physicians, and any events that damage
those relationships, or make it more difficult to build and maintain those relationships, could harm our business.

The  development,  marketing,  and  sale  of  our  products  depends  upon  our  ability  to  maintain  strong  working  relationships  with  physicians.  We  rely  on
these professionals to provide us with considerable knowledge and experience regarding the development, marketing and sale of our products. Physicians assist
us in clinical trials and as researchers, marketing and product consultants and public speakers. If we cannot maintain our strong working relationships with these
professionals  and  continue  to  receive  their  advice  and  input,  the  development  and  marketing  of  our  products  could  suffer,  which  could  harm  our  business,
financial  condition  and  results  of  operations.  The  medical  device  industry’s  relationship  with  physicians  is  under  increasing  scrutiny  by  the  Office  of  Inspector
General, or OIG, the Department of Justice, or DOJ, state attorneys general, and other foreign and domestic government agencies. Changes to or our failure to
comply  with  laws,  rules  and  regulations  governing  our  relationships  with  physicians,  or  an  investigation  into  our  compliance  by  the  OIG,  DOJ,  state  attorneys
general  and  other  government  agencies,  could  significantly  harm  our  business  by  damaging  our  reputation  among,  or  restricting  our  ability  to  work  with,
physicians.

In  addition,  we  target  our  sales  efforts  to  interventional  cardiologists,  vascular  surgeons  and  interventional  radiologists  because  they  are  often  the
physicians diagnosing and treating both coronary artery disease and PAD. If these physicians are not made aware of our Lumivascular platform products, those
patients may instead be surgically treated or treated with an alternative interventional procedure. In addition, there is a significant correlation between PAD and
coronary artery disease, and many physicians do not routinely screen for PAD while screening for coronary artery disease. If we are not successful in educating
physicians about screening for PAD and about the capabilities of our Lumivascular platform products, our ability to increase our revenues may be impaired.

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We compete against companies that have longer operating histories, more established products and greater resources, which may prevent us from
achieving significant market penetration, increasing our revenues or becoming profitable.

Our  products  compete  with  a  variety  of  products  and  devices  for  the  treatment  of  PAD,  including  other  CTO  crossing  devices,  stents,  balloons  and
atherectomy  catheters,  as  well  as  products  used  in  vascular  surgery.  Large  competitors  in  the  CTO  crossing,  stent  and  balloon  markets  include  Abbott
Laboratories, AngioDyamics, Boston Scientific, Cardinal Health, Cook Medical, Becton Dickinson and Medtronic. Competitors in the atherectomy market include
AngioDyamics, Boston Scientific, Cardiovascular Systems, Medtronic and Philips. Some competitors have previously attempted to combine intravascular imaging
with atherectomy and may have current programs underway to do so. These and other companies may attempt to incorporate on-board visualization into their
products  in  the  future  and  may  remain  competitive  with  us  in  marketing  traditional  technologies.  Other  competitors  include  pharmaceutical  companies  that
manufacture drugs for the treatment of symptoms associated with mild to moderate PAD and companies that provide products used by surgeons in peripheral and
coronary bypass procedures. These competitors and other companies may introduce new products that compete with our products. Many of our competitors have
significantly  greater  financial  and  other  resources  than  we  do  and  have  well-established  reputations,  as  well  as  broader  product  offerings  and  worldwide
distribution channels that are significantly larger and more effective than ours. In addition, competitors with greater financial resources than ours could acquire
other companies to gain enhanced name recognition and market share, as well as new technologies or products that could effectively compete with our existing
products, which may cause our revenues to decline and would harm our business. Competition with these companies could result in price-cutting, reduced profit
margins and loss of market share, any of which would harm our business, financial condition and results of operations.

If we are unable to effectively differentiate our products or company from those of our competitors and our business may be adversely affected.

If our manufacturing facility becomes damaged or inoperable, or we are required to vacate the facility, or our electronic systems are compromised,
our ability to manufacture and sell our Lumivascular platform products and to pursue our research and development efforts may be jeopardized.

We currently manufacture and assemble our Lumivascular platform products in-house. Our products are comprised of components sourced from a variety
of contract manufacturers, with final assembly completed at our facility in Redwood City, California. Our facility and equipment, or those of our suppliers, could be
harmed  or  rendered  inoperable  by  natural  or  man-made  disasters,  including  fire,  earthquake,  terrorism,  flooding  and  power  outages.  Further,  our  electronic
systems may experience service interruptions, denial-of-service and other cyber-attacks, computer viruses or other events. Any of these may render it difficult or
impossible for us to manufacture products, pursue our research and development efforts or otherwise run our business for some period of time. If our facility is
inoperable  for  even  a  short  period  of  time,  the  inability  to  manufacture  our  current  products,  and  the  interruption  in  research  and  development  of  any  future
products, may result in harm to our reputation, increased costs, lower revenues and the loss of customers. Furthermore, it could be costly and time-consuming to
repair or replace our facilities and the equipment we use to perform our research and development work and manufacture our products. 

We  depend  on  third-party  vendors  to  manufacture  some  of  our  components,  coating  and  sub-assemblies,  including  some  single  source  suppliers,
which could make us vulnerable to supply shortages and price fluctuations that could harm our business.

We currently manufacture some of our components and sub-assemblies at our Redwood City facility and rely on third-party vendors for other components
and sub-assemblies used in our Lumivascular platform. For several of our components and sub-assemblies we rely on single and limited source suppliers. For
example, we rely on single vendors for our optical fiber, coatings and drive cables that are key components of our catheters, and we rely on single vendors for our
laser and data acquisition card that are key components of our Lightbox. These components are critical to our products and there are relatively few alternative
sources of supply. We do not carry a significant inventory of these components. Our reliance on third-party vendors subjects us to a number of risks that could
impact our ability to manufacture our products and harm our business, including:

•

•

•

•

•

•

interruption of supply resulting from modifications to, or discontinuation of, a supplier’s operations;

delays in product shipments resulting from uncorrected defects, reliability issues or a supplier’s failure to consistently produce quality components;

price fluctuations due to a lack of long-term supply arrangements with our suppliers for key components;

inability to obtain adequate supply in a timely manner or on commercially reasonable terms;

difficulty identifying and qualifying alternative or additional suppliers for components in a timely manner;

inability of the manufacturer or supplier to comply with QSR as enforced by the FDA and state regulatory authorities;

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•

•

•

inability to control the quality of products manufactured by third parties;

production delays related to the evaluation and testing of products from alternative suppliers and corresponding regulatory qualifications; and

delays in delivery by our suppliers due to changes in demand from us or their other customers.

Any significant delay or interruption in the supply of components or sub-assemblies, or our inability to obtain substitute components, sub-assemblies or

materials from alternate sources at acceptable prices in a timely manner, could impair our ability to meet the demand of our customers and harm our business.

We depend on our senior management team and the loss of one or more key employees or an inability to attract and retain highly skilled employees
could harm our business.

Our success largely depends upon the continued services of our executive management team and key employees and the loss of one or more of our
executive officers or key employees could harm us and directly impact our financial results. Our employees may terminate their employment with us at any time.
Changes in our executive management team resulting from the hiring or departure of executives could disrupt our business.

We must attract and retain highly qualified personnel. Competition for skilled personnel is intense, especially for engineers with high levels of experience
in  designing  and  developing  medical  devices  and  for  sales  professionals.  We  have,  from  time  to  time,  experienced,  and  we  expect  to  continue  to  experience,
difficulty in hiring and retaining employees with appropriate qualifications. Many of the companies with which we compete for experienced personnel have greater
resources than we have. If we hire employees from competitors or other companies, their former employers may attempt to assert that these employees or we
have breached legal obligations, resulting in a diversion of our time and resources and, potentially, damages. In addition, job candidates and existing employees,
particularly in the San Francisco Bay Area, often consider the value of the stock awards they receive in connection with their employment. If the perceived value
of our stock awards declines, it may harm our ability to recruit and retain highly skilled employees. In addition, we invest significant time and expense in training
our  employees,  which  increases  their  value  to  competitors  who  may  seek  to  recruit  them.  If  we  fail  to  attract  new  personnel  or  fail  to  retain  and  motivate  our
current personnel, our business would be harmed.

We do not currently intend to devote significant additional resources in the near-term to market our Lumivascular platform internationally, which will
limit our potential revenues from our Lumivascular platform products.

Marketing  our  Lumivascular  platform  outside  of  the  United  States  would  require  substantial  additional  sales  and  marketing,  regulatory  and  personnel
expenses.  As  part  of  our  product  development  and  regulatory  strategy,  we  plan  to  expand  into  select  international  markets,  but  we  do  not  currently  intend  to
devote significant additional resources to market our Lumivascular platform internationally in order to focus our resources and efforts on the U.S. market. Our
decision to market our products primarily in the United States in the near-term will limit our ability to reach all of our potential markets and will limit our potential
sources of revenue. In addition, our competitors will have an opportunity to further penetrate and achieve market share outside of the United States until such
time, if ever, that we devote significant additional resources to market our Lumivascular platform products or other products internationally.

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Our ability to utilize our net operating loss carryforwards may be limited.

As of December 31, 2020, we had federal and state net operating loss carryforwards, or NOLs, due to prior period losses of $317.9 million and $209.7
million, respectively, which if not utilized will begin to expire in 2027 for federal purposes and 2027 for state purposes. Out of the total Federal net operating loss
carryforwards, $43.5 million were generated post December 31, 2017 and have no expiration. Generally, subject to certain limitations, NOLs can be used to offset
taxable income for U.S. federal income tax purposes. However, Section 382 of the Internal Revenue Code of 1986, as amended, may limit the NOLs we may use
in  any  year  for  U.S.  federal  income  tax  purposes  in  the  event  of  certain  changes  in  ownership  of  our  company.  A  Section  382  “ownership  change”  generally
occurs if one or more stockholders or groups of stockholders who own at least 5% of our stock increase their ownership by more than 50 percentage points over
their lowest ownership percentage within a rolling three-year period. Similar rules may apply under state tax laws. It is possible that prior transactions with respect
to our stock may have caused, and that future issuances or sales of our stock (including certain transactions involving our stock that are outside of our control)
could  cause,  an  “ownership  change.”  A  number  of  our  common  and  preferred  stock  financings  over  the  past  year  may  affect  our  ability  to  use  NOLs.  If  an
“ownership  change”  occurs,  Section  382  would  impose  an  annual  limit  on  the  amount  of  pre-ownership  change  NOLs  and  other  tax  attributes  we  can  use  to
reduce our taxable income, potentially increasing and accelerating our liability for income taxes, and also potentially causing those tax attributes to expire unused.
Any limitation on using NOLs could (depending on the extent of such limitation and the NOLs previously used) result in our retaining less cash after payment of
U.S. federal income taxes during any year in which we have taxable income (rather than losses) than we would be entitled to retain if such NOLs were available
as an offset against such income for U.S. federal income tax reporting purposes, which could harm our profitability. On December 22, 2017, the Tax Cuts and
Jobs  Act,  or  Tax  Act,  was  enacted  into  law  with  many  significant  changes  to  the  U.S.  tax  laws.  The  Tax  Act  limits  the  utilization  of  NOLs  arising  in  tax  years
beginning after December 31, 2017 to 80% of taxable income per year. However, existing NOLs that arose in years prior to December 31, 2017 are not affected
by these provisions. Our ability to utilize NOLs arising in future tax periods may be limited by the Tax Act.

The  ongoing  COVID-19  pandemic  and  responses  thereto  have  adversely  affected  and  we  expect  will  continue  to  adversely  affect  our  supply  chain,
workforce, approval process, and business operations.

In  December  2019,  a  novel  strain  of  coronavirus,  SARS-CoV-2,  was  reported  to  have  surfaced  in  Wuhan,  China.  Since  then,  SARS-CoV-2,  and  the
resulting disease COVID-19 has spread to multiple countries, including the United States and all of the primary markets where we conduct business. On March
10,  2020,  the  World  Health  Organization  declared  the  COVID-19  outbreak  a  pandemic,  and  the  U.S.  government-imposed  restrictions  on  travel  between  the
United  States  and  Europe  for  a  30-day  period.  Further,  on  March  13,  2020,  the  President  of  the  United  States  declared  the  COVID-19  pandemic  a  national
emergency,  invoking  powers  under  the  Stafford  Act,  the  legislation  that  directs  federal  emergency  disaster  response.  Almost  all  U.S.  states  and  many  local
jurisdictions have issued, and others in the future may issue, "shelter-in-place" orders, quarantines, executive orders and similar government orders, restrictions,
and recommendations for their residents to control the spread of COVID-19. Such orders, restrictions and recommendations, and the perception that additional
orders, restrictions or recommendations could occur, have resulted in widespread closures of businesses not deemed “essential,” work stoppages, slowdowns
and delays, work-from-home policies, travel restrictions and cancellation of events, as well as record declines in stock prices, among other effects. We continue to
monitor our operations and government mandates and may elect or be required to temporarily close our offices to protect our employees, and limit our access to
customers and limit customer use of our products as they are required to prioritize resources to address the public healthcare needs arising from the COVID-19
pandemic.  The  disruptions  to  our  activities  and  operations  will  negatively  impact  our  business,  some  of  our  operating  results  and  may  negatively  impact  our
financial condition. There is a risk that government actions will not be effective at containing COVID-19, and that government actions, including the orders and
restrictions  described  above,  that  are  intended  to  contain  the  spread  of  COVID-19  will  have  a  devastating  negative  impact  on  the  world  economy  at  large,  in
which case the risks to our sales, operating results and financial condition described herein would be elevated significantly.

The duration of COVID-19's impact on our business may be difficult to assess or predict. The widespread pandemic has resulted, and may continue to
result for an extended period, in significant disruption of global financial markets, reducing our ability to access capital, which would negatively affect our liquidity.
Further,  quarantines  or  government  reaction  or  shutdowns  could  disrupt  our  supply  chain.  Travel  and  import  restrictions  may  also  disrupt  our  ability  to
manufacture  or  distribute  our  devices.  Any  import  or  export  or  other  cargo  restrictions  related  to  our  products  or  the  raw  materials  used  to  manufacture  our
products would restrict our ability to manufacture and ship products and harm our business, financial condition and results of operations. Our key personnel and
other employees could also be affected by COVID-19, potentially reducing their availability, and an outbreak such as COVID-19 or the procedures we take to
mitigate its effect on our workforce could reduce the efficiency of our operations or prove insufficient. We may delay or reduce certain spending related to certain
projects until the travel and logistical impacts related to COVID-19 are lifted, which will delay the completion of such projects.

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In  addition,  the  conduct  of  clinical  trials  required  to  obtain  clearance  of  additional  indications  and  studies  gathering  post-market  data  for  some  of  our
products  previously  cleared  by  the  FDA  have  been,  and  we  expect  may  continue  to  be,  affected  by  the  COVID-19  pandemic.  Specifically,  site  initiation  and
patient enrollment have been delayed for one of our clinical studies, and we are experiencing delays in completing the INSIGHT clinical study with the current
restrictions on clinical work. As hospital resources are prioritized for the COVID-19 outbreak and quarantines impede patient movement or interrupt healthcare
services, these and other clinical studies may continue to be disrupted. If we are unable to successfully complete these or other clinical studies, and thus obtain
regulatory approvals and efficacy data sought, our business and operating results may be harmed.

While certain jurisdictions have begun easing restrictions on performing elective procedures, we cannot be certain that other jurisdictions will do so, or
that,  once  hospitals  do  begin  easing  restrictions  on  elective  procedures,  patients  will  begin  requesting  such  procedures.  Furthermore,  some  jurisdictions  have
experienced and continue to experience a resurgence in COVID-19 cases, which has prompted certain hospitals and other medical providers in such areas to
again defer elective procedures or further prolong or reinstate restrictions on such procedures. If other jurisdictions experience a resurgence in COVID-19 cases,
they may also prolong or reinstate restrictions on elective procedures. We have already experienced reduced sales as a result of the effects of the COVID-19
pandemic causing deferrals of elective procedures. While we experienced a rebound in sales during the third quarter of 2020 as practitioners and hospitals began
to once again perform elective procedures, it is unclear whether our sales will continue to increase and whether sales lost earlier in the year may be recoverable
in  the  future.  If  our  sales  decline,  or  if  such  lost  sales  are  not  recoverable  in  the  future,  our  business  and  results  of  operations  will  be  significantly  adversely
affected.

The global outbreak of COVID-19 continues to rapidly evolve. The ultimate impact of the COVID-19 outbreak is highly uncertain and subject to change,
and its duration and extent depends on factors such as the evolution of variants of the virus, and the development and widespread distribution of vaccines. We
do  not  yet  know  the  full  extent  of  potential  delays  or  impacts  on  our  business  or  the  global  economy  as  a  whole.  However,  these  effects  have  harmed  our
business,  financial  condition,  and  results  of  operations  in  the  near  term  and  could  have  a  continuing  material  impact  on  our  operations,  sales,  and  ability  to
continue operations.

Customer demand for and our ability to sell and market our products have been and we expect will continue to be adversely affected by the COVID-19
pandemic and responses thereto.

Restrictions on the ability to travel, social distancing policies, orders and restrictions, including those described above, and recommendations and fears of
COVID-19  spreading  within  medical  centers  has  caused  both  patients  and  providers  to  delay  or  cancel  procedures  that  use  our  devices.  We  are  unable  to
accurately  predict  when  these  policies,  orders  and  restrictions  will  be  relaxed  or  lifted,  and  there  can  be  no  assurances  that  patients  or  providers  will  restart
procedures  that  use  our  devices  upon  termination  of  these  policies,  orders  and  restrictions,  particularly  if  there  remains  any  continued  community  outbreak  of
COVID-19. A prolonged economic contraction or recession may also result in employer layoffs of their employees in markets where we conduct business, which
could result in lower procedure demand.

Our  sales  and  marketing  personnel  often  rely  on  in-person  and  onsite  access  to  healthcare  providers  which  is  currently  restricted  as  hospitals  reduce
access to essential personnel only. These restrictions have harmed our sales and marketing efforts, and continued restrictions would have a negative impact on
our  sales  and  results  of  operations.  An  increase  of  COVID-19-related  hospital  admissions  may  overload  hospitals  with  unexpected  patients,  thereby  delaying
further procedures that use our devices but that are deemed elective by the hospital. In addition, we made temporary salary and work hour reductions, though we
have  reverted  salaries  and  hours  to  prior  levels,  we  and  may,  in  the  future,  take  further  actions  including  reinstating  reductions  to  salary  and  work  hours,
furloughs, restructuring or layoffs, which may negatively impact our workforce and our business.

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We  may  not  be  eligible  to  participate  in  the  relief  programs  provided  under  the  recently  adopted  Coronavirus  Aid  Relief,  and  Economic  Security
(CARES) Act and even if we are eligible we may not realize any material benefits from participating in such programs.

On March 27, 2020, the President of the United States signed the Coronavirus Aid Relief, and Economic Security (CARES) Act into law. The CARES
Act, among other things, includes provisions relating to refundable payroll tax credits, deferment of employer side social security payments, net operating loss
carryback  periods,  alternative  minimum  tax  credit  refunds,  modifications  to  the  net  interest  deduction  limitations  and  technical  corrections  to  tax  depreciation
methods for qualified improvement property. We are evaluating the applicability of the CARES Act to the Company, and the potential impacts on our business. We
applied for, and received, a loan (the “PPP Loan”) in the principal amount of $2.3 million under the Paycheck Protection Program (the “PPP”) of the Cares Act.
The PPP Loan bears interest at a fixed rate of 1% annually and matures on April 20, 2022. Under the terms of the PPP, the principal may be forgiven if the Loan
proceeds are used for qualifying expenses as described in the CARES Act, such as payroll costs, benefits, rent, and utilities. In addition, on June 5, 2020, the
President of the United States signed the Paycheck Protection Program Flexibility Act (the “PPPFA”) into law. The PPPFA gives borrowers of a PPP loan more
flexibility and time to spend the loan proceeds and allows the funds to be used on broader categories of expenses while still qualifying for loan forgiveness. We
are  evaluating  forgiveness  requirements  pursuant  to  the  PPP  and  PPPFA  but  can  provide  no  guarantee  that  we  will  meet  any  of  the  requirements  for  loan
forgiveness. However, no assurance can be provided that the Company will obtain forgiveness of the PPP Loan in whole or in part. While we may determine to
apply for additional programs available under the CARES Act or other similar programs, there is no guarantee that we will meet any eligibility requirements to
participate in such programs or, even if we are able to participate, that such programs will provide meaningful benefit to our business.

We may not be entitled to forgiveness of our recently received PPP Loan, and our application for the PPP Loan could in the future be determined to
have been impermissible or could result in damage to our reputation.

On April 23, 2020 we received proceeds of $2.3 million from a loan under the Paycheck Protection Program of the CARES Act, a portion of which may be
forgiven, which we used to retain current employees, maintain payroll and make lease and utility payments. The PPP Loan matures on April 20, 2022 and bears
annual interest at a rate of 1.0%. Commencing on the date that is the later of (i) the date that is the 10th month after the end of the Company’s PPP Loan covered
period (as described below) and assuming the Company has applied for PPP Loan forgiveness within the period described in clause, which it did in December
2020  (ii),  the  date  on  which  SBA  remits  the  loan  forgiveness  amount  on  the  Company’s  PPP  Loan  to  the  PPP  lender  (or  notifies  such  lender  that  no  loan
forgiveness is allowed), we are required to pay the lender equal monthly payments of principal and interest as required to fully amortize by April 20, 2022 any
principal amount outstanding on the PPP Loan as of October 21, 2020. On June 5, 2020, the President of the United States signed the PPPFA into law. The
PPPFA gives borrowers of a PPP loan more flexibility and time to spend the loan proceeds and allows the funds to be used on broader categories of expenses
while still qualifying for loan forgiveness. A portion of the PPP Loan may be forgiven by the SBA upon our application and upon documentation of expenditures in
accordance with the SBA requirements. Under the CARES Act and the PPPFA, loan forgiveness is available for the sum of documented payroll costs, covered
rent payments, covered mortgage interest and covered utilities during the twenty-four week period or, if elected by the Company, the eight week period beginning
on the date of the loan is advanced. Not more than 40% of the forgiven amount may be for non-payroll costs. The amount of the PPP Loan eligible to be forgiven
may be limited due to declines in headcount, whether voluntary or involuntary, or if salaries and wages for employees with salaries of $100,000 or less annually
are  reduced  by  more  than  25%  as  compared  to  the  period  of  January  1,  2020  through  March  31,  2020.  We  will  be  required  to  repay  any  portion  of  the
outstanding principal that is not forgiven, along with accrued interest, in accordance with the amortization schedule described above, and we cannot provide any
assurance that we will be eligible for loan forgiveness, that we will ultimately apply for forgiveness, or that any amount of the PPP Loan will ultimately be forgiven
by the SBA. Furthermore, on April 28, 2020, the Secretary of the U.S. Department of the Treasury stated that the SBA will perform a full review of any PPP loan
over $2.0 million before forgiving the loan.

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In order to apply for the PPP Loan, we were required to certify, among other things, that the current economic uncertainty made the PPP Loan request
necessary to support our ongoing operations. We made this certification in good faith after analyzing, among other things, our financial situation and access to
alternative forms of capital, and believe that we satisfied all eligibility criteria for the PPP Loan, and that our receipt of the PPP Loan is consistent with the broad
objectives  of  the  Paycheck  Protection  Program  of  the  CARES  Act.  The  certification  described  above  does  not  contain  any  objective  criteria  and  is  subject  to
interpretation. On April 23, 2020, the SBA issued guidance stating that it is unlikely that a public company with substantial market value and access to capital
markets  will  be  able  to  make  the  required  certification  in  good  faith.  The  lack  of  clarity  regarding  loan  eligibility  under  the  Paycheck  Protection  Program  has
resulted  in  significant  media  coverage  and  controversy  with  respect  to  public  companies  applying  for  and  receiving  loans.  If,  despite  our  good-faith  belief  that
given  our  Company's  circumstances  we  satisfied  all  eligible  requirements  for  the  PPP  Loan,  we  are  later  determined  to  have  violated  any  of  the  laws  or
governmental regulations that apply to us in connection with the PPP Loan, such as the False Claims Act, or it is otherwise determined that we were ineligible to
receive the PPP Loan, we may be subject to penalties, including significant civil, criminal and administrative penalties and could be required to repay the PPP
Loan  in  its  entirety.  In  addition,  receipt  of  a  PPP  Loan  may  result  in  adverse  publicity  and  damage  to  reputation,  and  a  review  or  audit  by  the  SBA  or  other
government  entity  or  claims  under  the  False  Claims  Act  could  consume  significant  financial  and  management  resources.  Any  of  these  events  could  have  a
material adverse effect on our business, results of operations and financial condition.

We may acquire other companies or technologies or be the target of strategic transactions, which could divert our management ’s attention, result in
additional dilution to our stockholders and otherwise disrupt our operations and harm our operating results.

We may in the future seek to acquire or invest in businesses, applications or technologies that we believe could complement or expand our Lumivascular
platform, enhance our technical capabilities or otherwise offer growth opportunities. The pursuit of potential acquisitions may divert the attention of management
and cause us to incur various costs and expenses in identifying, investigating and pursuing suitable acquisitions, whether or not they are consummated. We may
not be able to identify desirable acquisition targets or be successful in entering into an agreement with any particular target or obtain the expected benefits of any
acquisition or investment.

To  date,  our  technology  and  product  development  efforts  have  been  organic,  and  we  have  no  experience  in  acquiring  other  businesses.  In  any
acquisition,  we  may  not  be  able  to  successfully  integrate  acquired  personnel,  operations  and  technologies,  or  effectively  manage  the  combined  business
following the acquisition. Acquisitions could also result in dilutive issuances of equity securities, the use of our available cash, or the incurrence of debt, which
could harm our operating results. In addition, if an acquired business fails to meet our expectations, our operating results, business and financial condition may
suffer.

In addition, we sometimes receive inquiries relating to potential strategic transactions, including from third parties who may seek to acquire us. We will
continue to consider and discuss such transactions as we deem appropriate. Such potential transactions may divert the attention of management, and cause us
to incur various costs and expenses in investigating and evaluating such transactions, whether or not they are consummated.

Risks Related to Our Use of Technology and Intellectual Property

If our technology infrastructure is compromised, damaged or interrupted by a cybersecurity incident, data security breach or other security problems,
our operating results and financial condition could be adversely affected.

We use technology in substantially all aspects of our business operations, and our ability to serve customers most effectively depends on the reliability of
our  technology  systems.  Cybersecurity  incidents  can  include  computer  viruses,  computer  denial-of-service  attacks,  worms,  and  other  malicious  software
programs or other attacks, covert introduction of malware to computers and networks, impersonation of authorized users, and efforts to discover and exploit any
design  flaws,  bugs,  security  vulnerabilities  or  security  weaknesses,  as  well  as  intentional  or  unintentional  acts  by  employees  or  other  insiders  with  access
privileges, intentional acts of vandalism by third parties and sabotage.

In  addition,  our  technology  infrastructure  and  systems  are  vulnerable  to  damage  or  interruption  from  natural  disasters,  power  loss  and
telecommunications  failures.  Any  such  disruption  to  our  systems,  or  the  technology  systems  of  third  parties  on  which  we  rely,  the  failure  of  these  systems  to
otherwise perform as anticipated, or the theft, destruction, loss, misappropriation, or release of sensitive and/or confidential information or intellectual property,
could require us to notify affected individuals, federal or state agencies or media outlets of the incident and could result in business disruption, negative publicity,
loss of customers, potential liability, including litigation or other legal actions against us or the imposition of penalties, fines, fees or liabilities, which may not be
covered  by  our  insurance  policies,  and  competitive  disadvantage,  any  or  all  of  which  would  potentially  adversely  affect  our  customer  service,  decrease  the
volume  of  our  business  and  result  in  increased  costs  and  lower  profits.  Moreover,  a  cybersecurity  breach  could  require  us  to  devote  significant  management
resources  to  address  the  problems  associated  with  the  breach  and  to  expend  significant  additional  resources  to  upgrade  further  the  security  measures  we
employ to protect information against cyber-attacks and other wrongful attempts to access such information, which could result in a disruption of our operations.

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While we have invested, and continue to invest, in technology security initiatives and other measures to prevent security breaches and cyber incidents, as
well as disaster recovery plans, these initiatives and measures may not be entirely effective to insulate us from technology disruption that could result in adverse
effects on our results of operations.

We may in the future be a party to intellectual property litigation or administrative proceedings that could be costly and could interfere with our ability
to sell our Lumivascular platform products.

The medical device industry has been characterized by extensive litigation regarding patents, trademarks, trade secrets, and other intellectual property
rights, and companies in the industry have used intellectual property litigation to gain a competitive advantage. It is possible that U.S. and foreign patents and
pending patent applications or trademarks controlled by third parties may be alleged to cover our products, or that we may be accused of misappropriating third
parties’ trade secrets. Additionally, our products include hardware and software components that we purchase from vendors, and may include design components
that  are  outside  of  our  direct  control.  Our  competitors,  many  of  which  have  substantially  greater  resources  and  have  made  substantial  investments  in  patent
portfolios,  trade  secrets,  trademarks,  and  competing  technologies,  may  have  applied  for  or  obtained  or  may  in  the  future  apply  for  or  obtain,  patents  or
trademarks that will prevent, limit or otherwise interfere with our ability to make, use, sell and/or export our products or to use product names. They may devote
substantial resources towards obtaining claims that cover the design of our atherectomy products to prevent the marketing and selling of competitive products.
We may become a party to patent or trademark infringement or trade secret claims and litigation as a result of these and other third-party intellectual property
rights being asserted against us. The defense and prosecution of these matters are both costly and time consuming. Vendors from whom we purchase hardware
or software may not indemnify us in the event that such hardware or software is accused of infringing a third-party’s patent or trademark or of misappropriating a
third-party’s trade secret.

Further,  if  such  patents,  trademarks,  or  trade  secrets  are  successfully  asserted  against  us,  this  may  harm  our  business  and  result  in  injunctions
preventing us from selling our products, license fees, damages and the payment of attorney fees and court costs. In addition, if we are found to willfully infringe
third-party patents or trademarks or to have misappropriated trade secrets, we could be required to pay treble damages in addition to other penalties. Although
patent,  trademark,  trade  secret,  and  other  intellectual  property  disputes  in  the  medical  device  area  have  often  been  settled  through  licensing  or  similar
arrangements, costs associated with such arrangements may be substantial and could include ongoing royalties. We may be unable to obtain necessary licenses
on satisfactory terms, if at all. If we do not obtain necessary licenses, we may not be able to redesign our Lumivascular platform products to avoid infringement.

Similarly,  interference  or  derivation  proceedings  provoked  by  third  parties  or  brought  by  the  U.S.  Patent  and  Trademark  Office,  or  USPTO,  may  be
necessary to determine the priority of inventions or other matters of inventorship with respect to our patents or patent applications. We may also become involved
in  other  proceedings,  such  as  re-examination,  inter  partes  review,  or  opposition  proceedings,  before  the  USPTO  or  other  jurisdictional  body  relating  to  our
intellectual  property  rights  or  the  intellectual  property  rights  of  others.  Adverse  determinations  in  a  judicial  or  administrative  proceeding  or  failure  to  obtain
necessary licenses could prevent us from manufacturing and selling our Lumivascular platform products or using product names, which would have a significant
adverse impact on our business.

Additionally, we may need to commence proceedings against others to enforce our patents or trademarks, to protect our trade secrets or know-how, or to
determine the enforceability, scope and validity of the proprietary rights of others. These proceedings would result in substantial expense to us and significant
diversion of effort by our technical and management personnel. We may not prevail in any lawsuits that we initiate and the damages or other remedies awarded,
if any, may not be commercially meaningful. We may not be able to stop a competitor from marketing and selling products that are the same or similar to our
products or from using product names that are the same or similar to our product names, and our business may be harmed as a result.

We are aware of patents held by third parties that may be asserted against us in litigation that could be costly and could limit our ability to sell our
Lumivascular platform products.

We are aware of patent families related to catheter positioning, optical coherence tomography, occlusion cutting and atherectomy owned by third parties.
With  regard  to  atherectomy  patents,  one  of  our  founders,  Dr.  John  Simpson,  founded  FoxHollow  Technologies  prior  to  founding  our  company.  FoxHollow
Technologies developed an atherectomy device that is currently sold by Medtronic, and Dr. Simpson and our Chief Technology Officer, Himanshu Patel, are listed
as inventors on patents covering that device that are now held by Medtronic. We are not currently aware of any claims Medtronic has made or intends to make
against  us  with  respect  to  Pantheris  or  any  other  product  or  product  under  development.  Because  of  a  doctrine  known  as  “assignor  estoppel,”  if  any  of
Dr. Simpson’s earlier patents are asserted against us by Medtronic, we may be prevented from asserting an invalidity defense regarding those patents, and our
defense may be compromised. Medtronic has significantly greater financial resources than we do to pursue patent litigation and could assert these patent families
against us at any time. Adverse determinations in any such litigation could prevent us from manufacturing or selling Pantheris or other products or products under
development, which would significantly harm our business.

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Intellectual property rights may not provide adequate protection, which may permit third parties to compete against us more effectively.

In  order  to  remain  competitive,  we  must  develop  and  maintain  protection  of  the  proprietary  aspects  of  our  technologies.  We  rely  on  a  combination  of
patents,  copyrights,  trademarks,  trade  secret  laws  and  confidentiality  and  invention  assignment  agreements  to  protect  our  intellectual  property  rights.  As  of
December  31,  2020,  we  held  38  issued  and  allowed  U.S.  patents,  1  U.S.  pending  provisional  application,  23  U.S.  utility  patent  applications  and  2  PCT
applications pending. As of December 31, 2020, we also had 75 issued and allowed patents from outside of the United States. As of December 31, 2020, we had
40  pending  patent  applications  outside  of  the  United  States,  including  in  Australia,  Canada,  China,  Europe,  India,  Japan  and  Mexico.  Our  patents  and  patent
applications  include  claims  covering  key  aspects  of  the  design,  manufacture  and  therapeutic  use  of  OCT  imaging  catheters,  occlusion-crossing  catheters,
atherectomy devices and our imaging console. Our patent applications may not result in issued patents and our patents may not be sufficiently broad to protect
our technology. Any patents issued to us may be challenged by third parties as being invalid, or third parties may independently develop similar or competing
technology that avoids our patents. Should such challenges be successful, competitors might be able to market products and use manufacturing processes that
are  substantially  similar  to  ours.  We  may  not  be  able  to  prevent  the  unauthorized  disclosure  or  use  of  our  technical  knowledge  or  other  trade  secrets  by
consultants, vendors or former or current employees, despite the existence generally of confidentiality agreements and other contractual restrictions. Monitoring
unauthorized use and disclosure of our intellectual property is difficult, and we do not know whether the steps we have taken to protect our intellectual property
will be adequate. In addition, the laws of many foreign countries will not protect our intellectual property rights to the same extent as the laws of the United States.
Consequently,  we  may  be  unable  to  prevent  our  proprietary  technology  from  being  exploited  abroad,  which  could  affect  our  ability  to  expand  to  international
markets or require costly efforts to protect our technology. To the extent our intellectual property protection is incomplete, we are exposed to a greater risk of
direct competition. In addition, competitors could purchase our products and attempt to replicate some or all of the competitive advantages we derive from our
development efforts or design around our protected technology. Our failure to secure, protect and enforce our intellectual property rights could substantially harm
the value of our Lumivascular platform, brand and business.

We use certain open source software in Lightbox. We may face claims from companies that incorporate open source software into their products or from
open source licensors, claiming ownership of, or demanding release of, the source code, the open source software or derivative works that were developed using
such software, or otherwise seeking to enforce the terms of the applicable open source license. These claims could result in litigation and could require us to
cease offering Lightbox unless and until we can re-engineer it to avoid infringement. This re-engineering process could require significant additional research and
development resources, and we may not be able to complete it successfully. These risks could be difficult to eliminate or manage, and, if not addressed, could
harm our business, financial condition and operating results.

Regulatory and Litigation Risks

If we fail to obtain and maintain necessary regulatory clearances or approvals for our Lumivascular platform products, or if clearances or approvals
for future products and indications are delayed or not issued, our commercial operations would be harmed.

Our Lumivascular platform products are medical devices that are subject to extensive regulation by FDA in the United States and by regulatory agencies

in other countries where we do business. Government regulations specific to medical devices are wide-ranging and govern, among other things:

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product design, development and manufacture;

laboratory, preclinical and clinical testing, labeling, packaging, storage and distribution;

pre-marketing clearance or approval;

record keeping;

product marketing, promotion and advertising, sales and distribution; and

post-marketing surveillance, including reporting of deaths or serious injuries and recalls and correction and removals.

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Before  a  new  medical  device,  or  a  new  intended  use  for,  an  existing  product  can  be  marketed  in  the  United  States,  a  company  must  first  submit  and
receive either 510(k) clearance or pre-marketing approval from FDA, unless an exemption applies. Either process can be expensive, lengthy and unpredictable.
We may not be able to obtain the necessary clearances or approvals or may be unduly delayed in doing so, which could harm our business. Furthermore, even if
we are granted regulatory clearances or approvals, they may include significant limitations on the indicated uses for the product, which may limit the market for
the  product.  Although  we  have  obtained  510(k)  clearance  to  market  our  Pantheris  family  of  catheters  for  atherectomy,  and  our  Ocelot  family  of  catheters  for
crossing  sub  and  total  occlusions  in  the  peripheral  vasculature,  our  clearance  can  be  revoked  if  safety  or  efficacy  problems  develop.  Delays  in  obtaining
clearance or approval could increase our costs and harm our revenues and growth.

In addition, we are required to timely file various reports with the FDA, including medical device reports, or MDRs, if our devices may have caused or
contributed to a death or serious injury or malfunctioned in a way that would likely cause or contribute to a death or serious injury if the malfunction were to recur.
If these MDRs are not filed timely, regulators may impose sanctions and sales of our products may suffer, and we may be subject to product liability or regulatory
enforcement actions, all of which could harm our business.

If  we  initiate  a  correction  or  removal  for  one  of  our  devices  to  reduce  a  risk  to  health  posed  by  the  device,  we  would  be  required  to  submit  a  publicly
available Correction and Removal report to the FDA and in many cases, similar reports to other regulatory agencies. This report could be classified by the FDA
as a device recall that could lead to increased scrutiny by the FDA, other international regulatory agencies and our customers regarding the quality and safety of
our devices. Furthermore, the submission of these reports has been and could be used by competitors against us in competitive situations and cause customers
to delay purchase decisions or cancel orders and would harm our reputation.

The FDA and the Federal Trade Commission, or FTC, also regulate the advertising and promotion of our products to ensure that the claims we make are
consistent with our regulatory clearances, that there are adequate and reasonable scientific data to substantiate the claims and that our promotional labeling and
advertising  is  neither  false  nor  misleading  in  any  respect.  If  the  FDA  or  FTC  determines  that  any  of  our  advertising  or  promotional  claims  are  misleading,  not
substantiated or not permissible, we may be subject to enforcement actions, including Warning Letters, adverse publicity, and we may be required to revise our
promotional claims and make other corrections or restitutions.

The FDA and state authorities have broad enforcement powers. Our failure to comply with applicable regulatory requirements could result in enforcement
action by the FDA or state agencies, which may include, among other things, harm to our reputation; fines, injunctions, civil penalties, or criminal prosecution;
product  replacements  or  recalls;  or  rejecting  our  requests  for  future  510(k)  clearance  or  pre-market  approval  or  withdrawal  of  a  previously  granted  510(k)
clearance. If any of these events were to occur, our business and financial condition would be harmed.

Material modifications to our Lumivascular platform products may require new 510(k)  clearances or pre-market approvals or may require us to recall
or cease marketing our Lumivascular platform products until clearances or approvals are obtained.

Material  modifications  to  the  intended  use  or  technological  characteristics  of  our  Lumivascular  platform  products  will  require  new  510(k)  clearances  or
pre-market  approvals  or  require  us  to  recall  or  cease  marketing  the  modified  devices  until  these  clearances  or  approvals  are  obtained  if  such  changes  were
made via the “Letter-to-File” process of internal documentation. Based on published FDA guidelines, the FDA requires device manufacturers to initially make and
document a determination of whether or not a modification requires a new approval, supplement or clearance; however, the FDA can review a manufacturer’s
decision. Any modification to an FDA-cleared device that would significantly affect its safety or efficacy or that would constitute a major change in its intended use
would require a new 510(k) clearance or possibly a pre-market approval. We may not be able to obtain additional 510(k) clearances or pre-market approvals for
new products or for modifications to, or additional indications for, our Lumivascular platform products in a timely fashion, or at all. Delays in obtaining required
future clearances would harm our ability to introduce new or enhanced products in a timely manner, which in turn would harm our future growth. We have made
modifications  to  our  Lumivascular  platform  products  in  the  past  and  will  make  additional  modifications  in  the  future  that  we  believe  do  not  or  will  not  require
additional clearances or approvals. If the FDA disagrees and requires new clearances or approvals for the modifications, we may be required to recall and to stop
selling or marketing our Lumivascular platform products as modified, which could harm our operating results and require us to redesign our Lumivascular platform
products. In these circumstances, we may be subject to significant enforcement actions. Future versions of are Lumivacular platform incorporating enhancements
may require additional regulatory clearances or approvals.

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Our ability to market our current products in the United States is limited to use in peripheral vessels, and if we want to market our products for other
uses, we will need to file for FDA clearances or approvals and may need to conduct trials to support expanded use, which would be expensive, time-
consuming and may not be successful.

Our  current  products  are  cleared  in  the  United  States  only  for  crossing  sub-total  and  chronic  total  occlusions  and  for  performing  atherectomy  in  the
peripheral  vasculature.  These  FFDCA  clearances  prohibits  us  from  marketing  or  advertising  our  products  for  any  other  indication  within  the  peripheral
vasculature, which restricts our ability to sell these products and could affect our growth. Additionally, our products are contraindicated for use in the cerebral,
carotid, coronary, iliac, and renal arteries. While off-label use of medical devices is common and the FDA does not regulate physicians’ choice of treatments, the
FDA does restrict a manufacturer’s communications regarding such off-label use. We are not allowed to actively promote or advertise our products for off-label
use.  In  addition,  we  cannot  make  comparative  claims  regarding  the  use  of  our  products  against  any  alternative  treatments  without  conducting  head-to-head
comparative clinical studies, which would be expensive and time consuming. If our promotional activities fail to comply with the FDA’s regulations or guidelines,
we may be subject to warnings or enforcement action by the FDA and other government agencies. In the future, if we want to market a variation of Ocelot or
Pantheris product families in the United States for use in other applications for which we do not currently have clearance, such as the coronary arteries, we will
need to make modifications to these products, conduct further clinical trials and obtain new clearances or approvals from the FDA. There can be no assurance
that  we  will  successfully  develop  these  modifications,  that  future  clinical  studies  will  be  successful  or  that  the  expense  of  these  activities  will  be  offset  by
additional revenues.

If our clinical trials are unsuccessful or significantly delayed, or if we do not complete our clinical trials, our business may be harmed.

Clinical  development  is  a  long,  expensive,  and  uncertain  process  and  is  subject  to  delays  and  the  risk  that  products  may  ultimately  prove  unsafe  or
ineffective in treating the indications for which they are designed. Completion of clinical trials may take several years or more and failure of the trial can occur at
any time. We cannot provide any assurance that our clinical trials will meet their primary endpoints or that such trials or their results will be accepted by the FDA
or foreign regulatory authorities. Even if we achieve positive early or preliminary results in clinical trials, these results do not necessarily predict final results, and
positive results in early trials may not indicate success in later trials. Many companies in the medical device industry have suffered significant setbacks in late-
stage clinical trials, even after receiving promising results in earlier trials or in the preliminary results from these late-stage clinical trials.

We may experience numerous unforeseen events during, or because of, the clinical trial process that could delay or prevent us from receiving regulatory

clearance or approval for new products or modifications of existing products, including new indications for existing products, including:

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negative or inconclusive results that may cause us to decide, or regulators may require us, to conduct additional clinical and/or preclinical testing which
may be expensive and time consuming;

trial results that do not meet the level of statistical significance required by the FDA or other regulatory authorities;

findings by the FDA or similar foreign regulatory authorities that the product is not sufficiently safe for investigational use in humans;

interpretations of data from preclinical testing and clinical testing by the FDA or similar foreign regulatory authorities that may be different from our own;

delays or failure to obtain approval of our clinical trial protocols from the FDA or other regulatory authorities;

delays in obtaining institutional review board approvals or government approvals to conduct clinical trials at prospective sites;

findings by the FDA or similar foreign regulatory authorities that our or our suppliers’ manufacturing processes or facilities are unsatisfactory;

changes in the review policies of the FDA or similar foreign regulatory authorities or the adoption of new regulations that may negatively affect or delay
our ability to bring a product to market or receive approvals or clearances to treat new indications;

trouble in managing multiple clinical sites;

delays in agreeing on acceptable terms with third-party research organizations and trial sites that may help us conduct the clinical trials; and

the suspension or termination by us, or regulators, of our clinical trials because the participating patients are being exposed to unacceptable health risks.

Failures  or  perceived  failures  in  our  clinical  trials  will  delay  and  may  prevent  our  product  development  and  regulatory  approval  process,  damage  our

business prospects and negatively affect our reputation and competitive position.

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From time to time, we engage outside parties to perform services related to certain of our clinical studies and trials, and any failure of those parties to
fulfill their obligations could increase costs and cause delays.

From time to time, we engage consultants to help design, monitor, and analyze the results of certain of our clinical studies and trials. The consultants we
engage interact with clinical investigators to enroll patients in our clinical trials. We depend on these consultants and clinical investigators to help facilitate the
clinical  studies  and  trials  and  monitor  and  analyze  data  from  these  studies  and  trials  under  the  investigational  plan  and  protocol  for  the  study  or  trial  and  in
compliance with applicable regulations and standards, commonly referred to as good clinical practices. We may face delays in our regulatory approval process if
these parties do not perform their obligations in a timely, compliant or competent manner. If these third parties do not successfully carry out their duties or meet
expected deadlines, or if the quality, completeness or accuracy of the data they obtain is compromised due to the failure to adhere to our clinical trial protocols or
for other reasons, our clinical studies or trials may be extended, delayed or terminated or may otherwise prove to be unsuccessful, and we may have to conduct
additional studies, which would significantly increase our costs, in order to obtain the regulatory clearances that we need to commercialize our products.

We have limited long-term data regarding the safety and efficacy of our Lumivascular platform products, including Pantheris. Any long-term data that
is generated by clinical trials involving our Lumivascular platform may not be positive or consistent with our short-term data, which would harm our
ability to obtain clearance to market and sell our products.

Our Lumivascular platform is a novel system, and our success depends on its acceptance by the medical community as being safe and effective, and
improving clinical outcomes. Important factors upon which the efficacy of our Lumivascular platform products, including Pantheris, will be measured are long-term
data on the rate of restenosis following our procedure, and the corresponding duration of patency, or openness of the artery, and publication of that data in peer-
reviewed  journals.  Another  important  factor  that  physicians  will  consider  is  the  rate  of  reintervention,  or  retreatment,  following  the  use  of  our  Lumivascular
platform products. The long-term clinical benefits of procedures that use our Lumivascular platform products are not known.

The results of short-term clinical experience of our Lumivascular platform products do not necessarily predict long-term clinical benefit. Restenosis rates
typically increase over time. We believe that physicians will compare the rates of long-term restenosis and reintervention for procedures using our Lumivascular
platform  products  against  alternative  procedures,  such  as  angioplasty,  stenting,  bypass  surgery  and  other  atherectomy  procedures.  If  the  long-term  rates  of
restenosis  and  reintervention  do  not  meet  physicians’  expectations,  our  Lumivascular  platform  products  may  not  become  widely  adopted  and  physicians  may
consider alternative treatments for their patients. Another significant factor that physicians will consider is acute safety data on complications that occur during the
use of our Lumivascular platform products. If the results obtained from any post-market studies that we conduct or post-clearance surveillance indicate that the
use of our Lumivascular platform products are not as safe or effective as other treatment options or as current short-term data would suggest, adoption of our
product  may  suffer  and  our  business  would  be  harmed.  In  addition,  we  are  responsible  for  the  costs  associated  with  conducting  studies  to  obtain  safety  and
efficacy  data.  If  we  are  unable  to  obtain  sufficient  financing,  whether  through  our  operations  or  from  third  parties,  we  will  not  be  able  to  conduct  the  studies
necessary to obtain long-term data regarding the safety and efficacy of our products.

Even  if  we  believe  the  data  collected  from  clinical  studies  or  clinical  experience  indicate  positive  results,  each  physician’s  actual  experience  with  our
products  will  vary.  Physicians  who  are  technically  proficient  participate  in  our  clinical  trials  and  are  high-volume  users  of  our  Lumivascular  platform  products.
Consequently, the results of our clinical trials and their experiences using our products may lead to better patient outcomes than those of physicians that are less
proficient, perform fewer procedures or who use our products infrequently.

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If we or our suppliers fail to comply with the FDA ’s QSR, our manufacturing operations could be delayed or shut down and Lumivascular platform
sales could suffer.

Our  manufacturing  processes  and  those  of  our  third-party  suppliers  are  required  to  comply  with  the  FDA’s  QSR,  which  covers  the  procedures  and
documentation of the design, testing, production, control, quality assurance, labeling, packaging, storage and shipping of our Lumivascular platform products. We
are also subject to similar state requirements and licenses. In addition, we must engage in extensive recordkeeping and reporting and must make available our
manufacturing  facilities  and  records  for  periodic  unannounced  inspections  by  governmental  agencies,  including  the  FDA,  state  authorities  and  comparable
agencies in other countries. If we fail a QSR inspection, our operations could be disrupted and our manufacturing interrupted. Failure to take adequate corrective
action in response to an adverse QSR inspection could result in, among other things, a shut-down of our manufacturing operations, significant fines, suspension
of marketing clearances and approvals, seizures or recalls of our device, operating restrictions and criminal prosecutions, any of which would cause our business
to suffer. Furthermore, our key component suppliers may not currently be or may not continue to be in compliance with applicable regulatory requirements, which
may result in manufacturing delays for our products and cause our revenues to decline.

We have registered with the FDA as a medical device manufacturer and have obtained a manufacturing license from the California Department of Public
Health (CDPH). The FDA has broad post-market and regulatory enforcement powers. We are subject to unannounced inspections by the FDA and the Food and
Drug Branch of CDPH to determine our compliance with the QSR and other regulations, and these inspections may include the manufacturing facilities of our
suppliers.  Our  current  facility  has  been  inspected  by  the  FDA  in  2009,  2011  and  2013,  and  two,  three  and  zero  observations,  respectively,  were  noted  during
those  inspections.  BSI,  our  European  Notified  Body,  inspected  our  facility  in  2014  and  2015  and  found  zero  non-conformances.  BSI  conducted  four  external
audits  in  2016  and  zero  non-conformances  were  found  in  all  except  for  one  audit,  for  which  four  minor  non-conformances  were  found.  BSI  conducted  a
recertification  audit  (for  EU)  in  2016  followed  by  surveillance  audits  in  2017  &  2018,  and  found  no  major  non-conformances.  BSI  also  audited  us  for  QSR
compliance under MDSAP (Medical Device Single Audit Program) for FDA in July 2016, and found no major non-conformances. Additionally, BSI conducted a
Technical File Audit in 2018 that resulted in one major non-conformance and three minor non-conformances. In 2018 and 2019, BSI conducted multiple routine
audits including a surveillance audit, a Microbiology audit, a MDSAP re-certification audit and most recently, a one-day unannounced audit in September 2019.
During  2020,  we  underwent  a  BSI  conducted  a  MDSAP  surveillance  audit  which  resulted  in  one  minor  non-conformance  and  no  major  non-conformances.  In
January 2021, BSI conducted a Microbiology audit which resulted in zero non-conformances. All non-conformances identified in the aforementioned audits have
been either successfully resolved or are being actively addressed via Avinger’s CAPA system.

We can provide no assurance that we will continue to remain in substantial compliance with the QSR. If the FDA, CDPH or BSI inspect our facility and
discover major compliance problems, we may have to shut down our facility and cease manufacturing until we can take the appropriate remedial steps to correct
the audit findings. Taking corrective action may be expensive, time consuming and a distraction for management and if we experience a shutdown or delay at our
manufacturing facility we may be unable to produce our Lumivascular platform products, which would harm our business.

Our Lumivascular platform products may in the future be subject to product recalls that could harm our reputation.

FDA and similar governmental authorities in other countries have the authority to require the recall of commercialized products in the event of material
regulatory  deficiencies  or  defects  in  design  or  manufacture.  A  government  mandated  or  voluntary  recall  by  us  could  occur  as  a  result  of  component  failures,
manufacturing  errors  or  design  or  labeling  defects.  Recalls  of  our  Lumivascular  platform  products  or  products  we  commercialize  in  the  future  would  divert
managerial attention, be expensive, harm our reputation with customers and harm our financial condition and results of operations. A recall announcement would
negatively affect our stock price.

Changes  in  coverage  and  reimbursement  for  procedures  using  our  Lumivascular  platform  products  could  affect  the  adoption  of  our  Lumivascular
platform and our future revenues.

Currently,  our  Lumivascular  platform  procedure  is  typically  reimbursed  by  third-party  payors,  including  Medicare  and  private  healthcare  insurance
companies, under existing reimbursement codes. These payors may change their coverage and reimbursement policies, as well as payment amounts, in a way
that would prevent or limit reimbursement for our products, which would significantly harm our business. Also, healthcare reform legislation or regulation may be
proposed or enacted in the future, which may adversely affect such policies and amounts. We cannot predict whether and to what extent existing coverage and
reimbursement  will  continue  to  be  available.  If  physicians,  hospitals  and  other  providers  are  unable  to  obtain  adequate  coverage  and  reimbursement  for
procedures  performed  using  our  Lumivascular  platform  products,  they  are  significantly  less  likely  to  use  our  Lumivascular  platform  products  and  our  business
would be harmed.

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Healthcare reform measures could hinder or prevent our planned products ’ commercial success.

In the United States, there have been, and we expect there will continue to be, a number of legislative and regulatory changes to the healthcare system
in ways that could harm our future revenues and profitability and the future revenues and profitability of our potential customers. Federal and state lawmakers
regularly  propose  and,  at  times,  enact  legislation  that  would  result  in  significant  changes  to  the  healthcare  system,  some  of  which  are  intended  to  contain  or
reduce the costs of medical products and services. The current presidential administration and Congress may continue to attempt broad sweeping changes to the
current healthcare laws. We face uncertainties that might result from modifications or repeal of any of the provisions of the Affordable Care Act, including as a
result of current and future executive orders and legislative actions. The impact of those changes on us and potential effect on the medical device industry as a
whole is currently unknown. Any changes to the Affordable Care Act are likely to have an impact on our results of operations and may have a material adverse
effect on our results of operations. We cannot predict what other healthcare programs and regulations will ultimately be implemented at the federal or state level
or the effect of any future legislation or regulation in the United States may have on our business.

The continuing efforts of the government, insurance companies, managed care organizations and other payors of healthcare services to contain or reduce

costs of healthcare may harm:

•

•

•

our ability to set a price that we believe is fair for our products;

our ability to generate revenues and achieve or maintain profitability; and

the availability of capital.

If  we  fail  to  comply  with  healthcare  regulations,  we  could  face  substantial  penalties  and  our  business,  operations  and  financial  condition  could  be
adversely affected.

Even though we do not and will not control referrals of healthcare services or bill directly to Medicare, Medicaid or other third-party payors, certain federal
and state healthcare laws and regulations pertaining to fraud and abuse and patients’ rights are and will be applicable to our business. We are subject to many
healthcare fraud and abuse and patient privacy regulations by both the federal government and the states in which we conduct our business. The regulations that
affect how we operate include:

•

•

•

•

•

•

the  federal  healthcare  program  Anti-Kickback  Statute,  which  prohibits,  among  other  things,  any  person  from  knowingly  and  willfully  offering,  soliciting,
receiving or providing remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual for, or the purchase, order or
recommendation  of,  any  good  or  service  for  which  payment  may  be  made  under  federal  healthcare  programs,  such  as  the  Medicare  and  Medicaid
programs;

the  federal  False  Claims  Act,  which  prohibits,  among  other  things,  individuals  or  entities  from  knowingly  presenting,  or  causing  to  be  presented,  false
claims, or knowingly using false statements, to obtain payment from the federal government;

federal  criminal  laws  that  prohibit  executing  a  scheme  to  defraud  any  healthcare  benefit  program  or  making  false  statements  relating  to  healthcare
matters;

the  Sunshine  Act,  created  under  the  Affordable  Care  Act,  and  its  implementing  regulations,  which  require  manufacturers  of  drugs,  medical  devices,
biologicals and medical supplies for which payment is available under Medicare, Medicaid, or the Children’s Health Insurance Program to report annually
to the HHS information related to payments or other transfers of value made to physicians and teaching hospitals, as well as ownership and investment
interests held by physicians and their immediate family members;

HIPAA, as amended by the HITECH Act, which protects the security and privacy of protected health information; and

state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or services reimbursed by
any third-party payor, including commercial insurers.

The Affordable Care Act, among other things, amends the intent requirement of the Federal Anti-Kickback Statute and criminal healthcare fraud statutes.
A person or entity no longer needs to have actual knowledge of this statute or specific intent to violate it. In addition, the Affordable Care Act provides that the
government may assert that a claim including items or services resulting from a violation of the Federal Anti-Kickback Statute constitutes a false or fraudulent
claim for purposes of the False Claims Act.

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Efforts  to  ensure  that  our  business  arrangements  will  comply  with  applicable  healthcare  laws  may  involve  substantial  costs.  It  is  possible  that
governmental  and  enforcement  authorities  will  conclude  that  our  business  practices  do  not  comply  with  current  or  future  statutes,  regulations  or  case  law
interpreting  applicable  fraud  and  abuse  or  other  healthcare  laws  and  regulations.  If  any  such  actions  are  instituted  against  us,  and  we  are  not  successful  in
defending  ourselves  or  asserting  our  rights,  those  actions  could  have  a  significant  impact  on  our  business,  including  the  imposition  of  civil,  criminal  and
administrative  penalties,  damages,  disgorgement,  monetary  fines,  possible  exclusion  from  participation  in  Medicare,  Medicaid  and  other  federal  healthcare
programs, contractual damages, reputational harm, diminished profits and future earnings, and curtailment of our operations, any of which could harm our ability
to  operate  our  business  and  our  results  of  operations.  In  addition,  the  clearance  or  approval  and  commercialization  of  any  of  our  products  outside  the  United
States will also likely subject us to foreign equivalents of the healthcare laws mentioned above, among other foreign laws.

Compliance with environmental laws and regulations could be expensive. Failure to comply with environmental laws and regulations could subject us
to significant liability.

Our research and development and manufacturing operations involve the use of hazardous substances and are subject to a variety of federal, state, local
and  foreign  environmental  laws  and  regulations  relating  to  the  safe  storage,  use,  discharge,  disposal,  remediation  of,  and  human  exposure  to,  hazardous
substances and the sale, labeling, collection, recycling, treatment and disposal of products containing hazardous substances, such as isopropyl alcohol and other
solvents. In addition, our research and development may acquire biological waste materials, such as human and animal tissue, for the sole use of product design
testing. Upon completion of the product testing, these biological wastes are safely disposed of following all federal, state, local and foreign environmental laws
and  regulations.  These  operations  are  permitted  by  regulatory  authorities,  and  the  resultant  waste  materials  are  disposed  of  in  material  compliance  with
environmental  laws  and  regulations.  Liability  under  environmental  laws  and  regulations  can  be  joint  and  several  and  without  regard  to  fault  or  negligence.
Compliance with environmental laws and regulations may be expensive and non-compliance could result in substantial liabilities, fines and penalties, personal
injury  and  third-party  property  damage  claims  and  substantial  investigation  and  remediation  costs.  Environmental  laws  and  regulations  could  become  more
stringent  over  time,  imposing  greater  compliance  costs  and  increasing  risks  and  penalties  associated  with  violations.  We  cannot  assure  you  that  violations  of
these laws and regulations will not occur in the future or have not occurred in the past as a result of human error, accidents, equipment failure or other causes.
The expense associated with environmental regulation and remediation could harm our financial condition and operating results.

The use, misuse or off-label use of the products in our Lumivascular platform may result in injuries that lead to product liability suits, which could be
costly to our business.

We  require  limited  training  in  the  use  of  our  Lumivascular  platform  products  because  we  market  primarily  to  physicians  who  are  experienced  in  the
interventional techniques required to use our device. If demand for our Lumivascular platform continues to grow, less experienced physicians will likely use the
devices, potentially leading to more injury and an increased risk of product liability claims. The use or misuse of our Lumivascular platform products has in the
past resulted, and may in the future result, in complications, including damage to the treated artery, infection, internal bleeding, and limb loss, potentially leading
to product liability claims. Our Lumivascular platform products are contraindicated for use in the carotid, cerebral, coronary, iliac, or renal arteries. Our sales force
does  not  promote  the  use  of  our  products  for  off-label  indications,  and  our  U.S.  instructions  for  use  specify  that  our  Lumivascular  platform  products  are  not
intended for use in the carotid, cerebral, coronary, iliac or renal arteries. However, we cannot prevent a physician from using our Lumivascular platform products
for  these  off-label  applications.  The  application  of  our  Lumivascular  platform  products  to  coronary  arteries,  as  opposed  to  peripheral  arteries,  is  more  likely  to
result  in  complications  that  have  serious  consequences.  For  example,  if  excised  plaque  were  not  captured  properly  in  our  device,  it  could  be  carried  by  the
bloodstream  to  a  more  narrow  location,  blocking  a  coronary  artery,  leading  to  a  heart  attack,  or  blocking  an  artery  to  the  brain,  leading  to  a  stroke.  If  our
Lumivascular  platform  products  are  defectively  designed,  manufactured  or  labeled,  contain  defective  components  or  are  misused,  we  may  become  subject  to
costly  litigation  initiated  by  our  customers  or  their  patients.  Product  liability  claims  are  especially  prevalent  in  the  medical  device  industry  and  could  harm  our
reputation, divert management’s attention from our core business, be expensive to defend and may result in sizable damage awards against us. Although we
maintain product liability insurance, the amount or breadth of our coverage may not be adequate for the claims that are made against us.

The  expense  and  potential  unavailability  of  insurance  coverage  for  liabilities  resulting  from  our  products  could  harm  us  and  our  ability  to  sell  our
Lumivascular platform products.

We may not have sufficient insurance coverage for future product liability claims. We may not be able to obtain insurance in amounts or scope sufficient
to  provide  us  with  adequate  coverage  against  all  potential  liabilities.  Any  product  liability  claims  brought  against  us,  with  or  without  merit,  could  increase  our
product liability insurance rates or prevent us from securing continuing coverage, harm our reputation in the industry, significantly increase our expenses, and
reduce  product  sales.  Product  liability  claims  in  excess  of  our  insurance  coverage  would  be  paid  out  of  cash  reserves,  harming  our  financial  condition  and
operating results.

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Some of our customers and prospective customers may have difficulty in procuring or maintaining liability insurance to cover their operations and use of
our  Lumivascular  platform  products.  Medical  malpractice  carriers  are  also  withdrawing  coverage  in  certain  states  or  substantially  increasing  premiums.  If  this
trend continues or worsens, our customers may discontinue using our Lumivascular platform products and potential customers may opt against purchasing our
Lumivascular platform products due to the cost or inability to procure insurance coverage.

Risks Related to Our Organizational Structure

Our stock price may be volatile, and purchasers of our common stock could incur substantial losses.

Our stock price has fluctuated significantly since our IPO and is likely to continue to fluctuate substantially. As a result of this price fluctuation, investors
may experience losses on their investments in our stock. In addition, the development stage of our operations may make it difficult for investors to evaluate the
success of our business to date and to assess our future viability. The market price for our common stock may be influenced by many factors, including:

•

sales of stock by our existing stockholders, including our affiliates;

• market acceptance of our Lumivascular platform and products;

•

•

•

•

•

•

•

•

•

•

•

•

•

the results of our clinical trials;

changes in analysts’ estimates, investors’ perceptions, recommendations by securities analysts or our failure to achieve analysts’ and our own estimates;

the financial projections we may provide to the public, any changes in these projections or our failure to meet these projections;

actual or anticipated fluctuations in our financial condition and operating results;

quarterly variations in our or our competitors’ results of operations;

general market conditions and other factors unrelated to our operating performance or the operating performance of our competitors;

changes  in  operating  performance  and  stock  market  valuations  of  other  technology  companies  generally,  or  those  in  the  medical  device  industry  in
particular;

the loss of key personnel, including changes in our board of directors and management;

legislation or regulation of our business;

lawsuits threatened or filed against us;

the announcement or approvals of new products or product enhancements by us or our competitors;

announcements related to patents issued to us or our competitors and to litigation; and

developments in our industry.

From  time  to  time,  our  affiliates  may  sell  stock  for  reasons  due  to  their  personal  financial  circumstances.  These  sales  may  be  interpreted  by  other
stockholders as an indication of our performance and result in subsequent sales of our stock that have the effect of creating downward pressure on the market
price of our common stock. In addition, the stock prices of many companies in the medical device industry have experienced wide fluctuations that have often
been unrelated to the operating performance of those companies.

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The market price and trading volume of our common stock has been volatile over the past year and it may continue to be volatile. Over the past year, our
common stock has traded as low as $0.23 and as high as $1.25 per share. We cannot predict the price at which our common stock will trade in the future and it
may  decline.  The  price  at  which  our  common  stock  trades  may  fluctuate  significantly  and  may  be  influenced  by  many  factors,  including  our  financial  results;
developments  generally  affecting  our  industry;  general  economic,  industry  and  market  conditions;  the  depth  and  liquidity  of  the  market  for  our  common  stock;
investor  perceptions  of  our  business;  reports  by  industry  analysts;  announcements  by  other  market  participants,  including,  among  others,  investors,  our
competitors,  and  our  customers;  regulatory  action  affecting  our  business;  and  the  impact  of  other  “Risk  Factors”  discussed  in  this  Annual  Report.  In  addition,
changes in the trading price of our common stock may be inconsistent with our operating results and outlook. The volatility of the market price of our common
stock may adversely affect investors’ ability to purchase or sell shares of our common stock.

We may fail to meet our publicly announced guidance or other expectations about our business and future operating results, which would cause our
stock price to decline.

We have provided in the past and may provide guidance in the future about our business and future operating results. In developing this guidance, our
management must make certain assumptions and judgments about our future performance, including projected revenues and the timing of regulatory approvals.
Furthermore, analysts and investors may develop and publish their own projections of our business, which may form a consensus about our future performance.
Our business results may vary significantly from such guidance or that consensus due to a number of factors, many of which are outside of our control, and which
could adversely affect our operations and operating results. Furthermore, if we make downward revisions of our previously announced guidance, or if our publicly
announced guidance of future operating results fails to meet expectations of securities analysts, investors or other interested parties, the price of our common
stock would decline. 

If securities or industry analysts do not publish research or reports about our business, or publish negative reports about our business, our share
price and trading volume could decline.

The  trading  market  for  our  common  stock  will  depend  in  part  on  the  research  and  reports  that  securities  or  industry  analysts  publish  about  us  or  our
business, our market and our competitors. We do not have any control over these analysts. The analysts who previously published research reports on our stock
following  our  IPO  have  discontinued  coverage.  Although  one  new  analyst  initiated  coverage  of  our  business  in  September  2019,  if  additional  analysts  do  not
begin regularly publishing reports on us, we could lose visibility in the financial markets, which could cause our share price or trading volume to decline.

Sales  of  a  substantial  number  of  shares  of  our  common  stock  in  the  public  market,  including  by  our  existing  stockholders,  could  cause  our  stock
price to fall.

Sales  of  a  substantial  number  of  shares  of  our  common  stock  in  the  public  market,  or  the  perception  that  these  sales  might  occur,  could  depress  the
market price of our common stock and could impair our ability to raise capital through the sale of additional equity securities. We are unable to predict the effect
that these sales and others may have on the prevailing market price of our common stock.

We  will  need  to  raise  additional  funds  through  future  equity  or  debt  financings  to  meet  our  operational  needs  and  capital  requirements  for  product
development, clinical trials and commercialization. We can provide no assurance that we will be successful in raising funds pursuant to additional equity or debt
financings or that such funds will be raised at prices that do not create substantial dilution for our existing stockholders. Given our stock price, any financing that
we undertake in the future could cause substantial dilution to our existing stockholders.

On March 7, 2019, we filed a universal shelf registration statement (the “Shelf Registration Statement”) to offer up to $50.0 million of our securities. We
have established, and may in the future establish, “at-the-market” programs pursuant to which we may offer and sell shares of our common stock pursuant to the
Shelf Registration Statement. Due to the SEC’s “baby shelf rules,” which prohibit companies with a public float of less than $75 million from issuing securities
under a shelf registration statement in excess of one-third of such company’s public float in a twelve-month period. In the past, we were limited to using the Shelf
Registration Statement. We are no longer limited from issuing securities under the Shelf Registration Statement.

Our  directors  and  employees  may  sell  our  stock  through  10b5-1  trading  plans  or  in  the  market  during  open  windows  under  our  insider  trading  policy
without such plans in place. Sales of our common stock by our directors and employees could be perceived negatively by investors or cause downward pressure
on our common stock and cause a reduction in the price of our common stock as a result. We have also registered shares of our common stock that we may
issue under our employee equity incentive plans. These shares will be able to be sold freely in the public market upon issuance.

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The  requirements  of  being  a  public  company  may  strain  our  resources,  divert  management ’s  attention  and  affect  our  ability  to  attract  and  retain
executive management and qualified board members.

As  a  public  company,  we  are  subject  to  the  reporting  requirements  of  the  Securities  Exchange  Act  of  1934,  as  amended,  or  the  Exchange  Act,  the
Sarbanes-Oxley Act, the Dodd-Frank Act, the listing requirements of Nasdaq and other applicable securities laws, rules and regulations. Compliance with these
laws, rules and regulations have increased our legal and financial compliance costs and will make some activities more difficult, time-consuming or costly and
increase demand on our systems and resources, particularly after we are no longer an “emerging growth company.” The Exchange Act requires, among other
things,  that  we  file  annual,  quarterly  and  current  reports  with  respect  to  our  business  and  operating  results.  The  Sarbanes-Oxley  Act  requires,  among  other
things, that we maintain effective disclosure controls and procedures and internal control over financial reporting. In order to maintain and, if required, improve our
disclosure controls and procedures and internal control over financial reporting to meet this standard, significant resources and management oversight may be
required.  Our  management  and  other  personnel  now  need  to  devote  a  substantial  amount  of  time  to  these  compliance  initiatives.  As  a  result,  management’s
attention may be diverted from other business concerns and our costs and expenses will increase, which could harm our business and operating results. We may
need to hire more employees in the future or engage outside consultants to comply with these requirements, which will increase our costs and expenses.

In  addition,  changing  laws,  regulations  and  standards  relating  to  corporate  governance  and  public  disclosure  are  creating  uncertainty  for  public
companies, increasing legal and financial compliance costs and making some activities more time consuming. These laws, regulations and standards are subject
to varying interpretations, in many cases due to their lack of specificity and, as a result, their application in practice may evolve over time as new guidance is
provided by regulatory and governing bodies. This could result in continuing uncertainty regarding compliance matters and higher costs necessitated by ongoing
revisions to disclosure and governance practices. We intend to invest resources to comply with evolving laws, regulations and standards, and this investment may
result in increased general and administrative expenses and a diversion of management’s time and attention from revenue-generating activities to compliance
activities. If our efforts to comply with new laws, regulations and standards differ from the activities intended by regulatory or governing bodies due to ambiguities
related to their application and practice, regulatory authorities may initiate legal proceedings against us and our business may be harmed.

We  will  incur  additional  compensation  costs  in  the  event  that  we  decide  to  pay  our  executive  officers  cash  compensation  closer  to  that  of  executive
officers  of  other  public  medical  device  companies,  which  would  increase  our  general  and  administrative  expense  and  could  harm  our  profitability.  Any  future
equity awards will also increase our compensation expense. We also expect that being a public company and compliance with applicable rules and regulations
will  make  it  more  expensive  for  us  to  obtain  director  and  officer  liability  insurance,  and  we  may  be  required  to  accept  reduced  coverage  or  incur  substantially
higher costs to obtain coverage. These factors could also make it more difficult for us to attract and retain qualified executive officers and members of our board
of directors, particularly to serve on our audit committee and compensation committee.

As a result of disclosure of information in this Annual Report on Form 10-K and in other filings required of a public company, our business and financial
condition will become more visible, which could be advantageous to our competitors and clients and could result in threatened or actual litigation, including by
competitors and other third parties. If such claims are successful, our business and operating results could be harmed, and even if the claims are resolved in our
favor, these claims, and the time and resources necessary to resolve them, could divert the resources of our management and harm our business and operating
results.

Nasdaq may delist our securities from its exchange, which could harm our business and limit our stockholders ’ liquidity.

Our common stock is currently listed on the Nasdaq Capital Market, which has qualitative and quantitative listing criteria. However, we cannot assure you
that our common stock will continue to be listed on Nasdaq in the future. In order to continue listing our common stock on Nasdaq, we must maintain certain
financial, distribution and stock price levels. Generally, we must maintain a minimum amount in stockholders’ equity, a minimum number of holders of our common
stock and a minimum bid price.

On  March  10,  2020,  we  received  a  letter  from  Nasdaq’s  Listing  Qualifications  Department  notifying  us  that  the  Company  was  not  in  compliance  with
Nasdaq Listing Rule 5550(a)(2), as the minimum bid price for the Company’s listed securities was less than $1 for the previous 30 consecutive business days.
The Company initially had a period of 180 calendar days, or until September 8, 2020, to regain compliance with the rule referred to in this paragraph. On April 20,
2020,  we  received  a  subsequent  written  notice  from  Nasdaq  indicating  that  Nasdaq  filed  an  immediately  effective  rule  change  with  SEC  on  April  16,  2020,
pursuant which the compliance periods for bid price and market value of publicly held shares requirements were tolled through June 30, 2020, meaning that the
Company had until November 20, 2020 to regain compliance with Nasdaq’s minimum bid price requirement. The Company did not regain compliance with the
minimum bid price requirement by November 20, 2020. In accordance with Nasdaq Listing Rule 5810(c)(3)(A), the Company provided written notice to Nasdaq of
its intent to cure the deficiency and, on November 24, 2020, the Company received notice that Nasdaq granted the Company an additional 180 calendar days, or
until May 19, 2021, to regain compliance.

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On January 26, 2021, the Company received a letter from Nasdaq notifying the Company that the Staff had determined that the closing bid price of the
Company’s common stock had been at $1.00 per share or greater for at least 10 consecutive business days and, accordingly, that the Company had regained
compliance with the minimum bid price requirement for continued listing on the Nasdaq Stock Market and that the matter is now closed. While the Company has
regained  compliance  with  the  minimum  bid  price  requirement,  there  can  be  no  assurance  that  the  Company  will  be  able  to  maintain  compliance  with  the
minimum bid price requirement in the future.

If Nasdaq delists our common stock from trading on its exchange and we are not able to list our securities on another national securities exchange, we

expect our securities could be quoted on an over-the-counter market. If this were to occur, we could face significant material adverse consequences, including:

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a limited availability of market quotations for our securities;

reduced liquidity for our securities;

a determination that our common stock is a “penny stock” which will require brokers trading in our common stock to adhere to more stringent rules and
possibly result in a reduced level of trading activity in the secondary trading market for our securities;

a limited amount of news and analyst coverage; and

a decreased ability to issue additional securities or obtain additional financing in the future.

The National Securities Markets Improvement Act of 1996, which is a federal statute, prevents or preempts the states from regulating the sale of certain
securities, which are referred to as “covered securities.” If our common stock continues to be listed on NASDAQ, our common stock will be a covered security.
Although  the  states  are  preempted  from  regulating  the  sale  of  our  securities,  the  federal  statute  does  allow  the  states  to  investigate  companies  if  there  is  a
suspicion of fraud, and, if there is a finding of fraudulent activity, then the states can regulate or bar the sale of covered securities in a particular case.

Anti-takeover provisions in our amended and restated certificate of incorporation and bylaws and Delaware law could discourage a takeover.

Our  amended  and  restated  certificate  of  incorporation  and  bylaws  contain  provisions  that  might  enable  our  management  to  resist  a  takeover.  These

provisions include:

•

•

•

•

•

•

•

•

•

•

a classified board of directors;

advance notice requirements applicable to stockholders for matters to be brought before a meeting of stockholders and requirements as to the form and
content of a stockholder’s notice;

a supermajority stockholder vote requirement for amending certain provisions of our amended and restated certificate of incorporation and bylaws;

the right to issue preferred stock without stockholder approval, which could be used to dilute the stock ownership of a potential hostile acquirer;

allowing stockholders to remove directors only for cause;

a requirement that the authorized number of directors may be changed only by resolution of the board of directors;

allowing all vacancies, including newly created directorships, to be filled by the affirmative vote of a majority of directors then in office, even if less than a
quorum, except as otherwise required by law;

a requirement that our stockholders may only take action at annual or special meetings of our stockholders and not by written consent;

limiting the forum for certain litigation against us to Delaware; and

limiting  the  persons  that  can  call  special  meetings  of  our  stockholders  to  our  board  of  directors,  the  chairperson  of  our  board  of  directors,  the  chief
executive officer or the president (in the absence of a chief executive officer).

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These  provisions  might  discourage,  delay  or  prevent  a  change  in  control  of  our  company  or  a  change  in  our  management.  The  existence  of  these
provisions could adversely affect the voting power of holders of common stock and limit the price that investors might be willing to pay in the future for shares of
our common stock. In addition, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General Corporation
Law, which generally prohibits a Delaware corporation from engaging in any of a broad range of business combinations with any “interested” stockholder for a
period of three years following the date on which the stockholder became an “interested” stockholder.

Our  amended  and  restated  certificate  of  incorporation  provides  that  the  Court  of  Chancery  of  the  State  of  Delaware  will  be  the  sole  and  exclusive
forum for substantially all disputes between us and our stockholders, which could limit our stockholders’ ability to obtain a favorable judicial forum
for disputes with us or our directors, officers or employees.

Our amended and restated certificate of incorporation provides that, unless we consent in writing to the selection of an alternative forum, the Court of
Chancery of the State of Delaware is the sole and exclusive forum for (i) any derivative action or proceeding brought on our behalf, (ii) any action asserting a
claim of breach of fiduciary duty owed by any of our directors, officers or other employees to us or to our stockholders, (iii) any action asserting a claim arising
pursuant to the Delaware General Corporation Law or our certificate of incorporation or bylaws (iv) any action to interpret, apply, enforce or determine the validity
of our certificate of incorporation or bylaws, or (v) any action asserting a claim governed by the internal affairs doctrine. This exclusive forum provision would not
apply  to  suits  brought  to  enforce  any  liability  or  duty  created  by  the  Securities  Act  or  the  Exchange  Act  or  any  other  claim  for  which  the  federal  courts  have
exclusive  jurisdiction.  To  the  extent  that  any  such  claims  may  be  based  upon  federal  law  claims,  Section  27  of  the  Exchange  Act  creates  exclusive  federal
jurisdiction over all suits brought to enforce any duty or liability created by the Exchange Act or the rules and regulations thereunder. Furthermore, Section 22 of
the Securities Act creates concurrent jurisdiction for federal and state courts over all suits brought to enforce any duty or liability created by the Securities Act or
the rules and regulations thereunder.

This  choice  of  forum  provision  may  limit  a  stockholder’s  ability  to  bring  a  claim  in  a  judicial  forum  that  it  finds  favorable  for  disputes  with  us  or  our
directors, officers or employees, which may discourage such lawsuits against us and our directors, officers or employees. If a court were to find the choice of
forum  provision  contained  in  our  certificate  of  incorporation  to  be  inapplicable  or  unenforceable  in  an  action,  we  may  incur  additional  costs  associated  with
resolving such action in other jurisdictions, which could have a material adverse effect on our business, financial condition, results of operations and prospects.

We have not paid cash dividends in the past and do not expect to pay cash dividends in the future, and any return on investment may be limited to
the value of our stock.

We have never paid cash dividends and do not anticipate paying cash dividends in the foreseeable future. The payment of dividends will depend on our
earnings, capital requirements, financial condition, prospects and other factors our board of directors may deem relevant. In addition, our Loan Agreement with
CRG prohibits us from, among other things, paying any dividends or making any other distribution or payment on account of our common stock. The terms of our
Series A preferred stock and our Series B preferred stock provide that we may not pay dividends on our common stock without concurrently declaring dividends
on each. If we do not pay dividends, our stock may be less valuable because a return on your investment will only occur if you sell our common stock after our
stock price appreciates. For more information on restrictions governing our ability to pay dividends, see the section titled “Dividend Policy” below.

CRG  has  the  ability  to  exert  significant  control  over  matters  pursuant  to  the  protective  provisions  therein  as  well  as  the  covenants  and  other
restrictions in the Loan Agreement.

Even though Series A preferred stock is non-voting stock, our governing documents, as amended, have protective provisions that will require CRG to
consent to certain significant Company events. For example, CRG’s consent would be necessary to create additional shares of Series A preferred stock, amend
our organizational documents, or approve any merger, sale of assets, or other major corporate transaction. This consent requirement could delay or prevent any
acquisition of our company on terms that other stockholders may desire, and may adversely affect the market price of our common stock.

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The Series A preferred stock has a liquidation preference senior to our common stock and Series B preferred stock.

Series  A  preferred  stock  has  a  liquidation  preference  that  gets  paid  prior  to  any  payment  on  our  common  stock  (including  shares  issuable  upon  the
exercise of our outstanding warrants) and Series B preferred stock. As a result, if we were to dissolve, liquidate, merge with another company or sell our assets,
the holders of our Series A preferred stock would have the right to receive up to approximately $52.2 million as of December 31, 2020, plus any unpaid dividends
from any such transaction before any amount is paid to the holders of our Series B preferred stock or common stock or pursuant to the redemption rights in the
warrants  for  fundamental  transactions.  The  payment  of  the  liquidation  preferences  could  result  in  common  stockholders,  Series  B  preferred  stockholders  and
warrant holders not receiving any consideration if we were to liquidate, dissolve or wind up, either voluntarily or involuntarily. In January 2019, December 2019
and December 2020, 2,945, 3,580 and 3,866 additional shares of Series A preferred stock, respectively, were issued to CRG as payment of dividends accrued
through December 31, 2020.

The existence of the liquidation preferences may reduce the value of our common stock, make it harder for us to sell shares of common stock in offerings

in the future, or prevent or delay a change of control.

We have limited shares available for issuance to raise capital to fund our operations and grant stock-based incentive awards to employees, directors,
and consultants. If we are unable to increase the number of shares of common stock available for issuance, our business will be adversely affected.

Currently, we have 100,000,000 authorized shares of common stock. As of February 26, 2021, we had 95,298,129 shares of common stock outstanding.
After taking into account the 3,173,462 shares reserved for issuance upon the exercise of outstanding options and warrants, and vesting of restricted stock units,
we have a very limited number of shares available for issuance. For all practical purposes, the authorized shares of our common stock have been fully utilized,
restricting our ability to issue any more shares. At our annual meeting in December 2020, we solicited our shareholders to approve a reverse stock split, which
would  decrease  the  number  of  outstanding  shares  and  allow  additional  shares  to  be  issued  in  future  offerings;  however,  we  did  not  receive  the  requisite
shareholder approval. We plan to present proposals at our 2021 annual meeting of stockholders to amend our Amended and Restated Certificate of Incorporation
to (a) effect a reverse stock split or (b) increase the number of authorized shares of common stock. However, if such proposals are not approved, we will have
virtually no shares available for issuance to raise capital to fund our operations, make grants of stock-based incentive awards, or take such other actions requiring
available  capital  stock  needed  to  operate  our  business.  Further  delays  in  securing,  or  the  failure  to  secure,  shareholder  approval  for  a  reverse  stock  split  or
approval  to  amend  our  certificate  of  incorporation  to  increase  the  number  of  authorized  shares  of  common  may  prevent  us  from  executing  a  capital  raising
transaction, which may have a material adverse effect on our business and financial condition.

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ITEM 1B.    UNRESOLVED STAFF COMMENTS

None.

ITEM 2.    PROPERTIES

Through November 30, 2019, we maintained our principal executive offices, comprising 44,200 square feet in two buildings in Redwood City, California,
under a lease agreement that was originally to expire in November 2019. On April 1, 2019, we entered into an amendment to the lease which extended the lease
term for an additional period of five years subsequent to the original expiration of November 30, 2019. As amended, the lease will expire on November 30, 2024.
Under the terms of the amendment, we are obligated to pay approximately $5.8 million in base rent payments through November 2024, beginning on December
1, 2019. This amendment does not extend the term of the lease with respect to the building being subleased. Our facility houses our research and development,
sales, marketing, manufacturing, finance and administrative activities.

On October 19, 2017, we entered into an agreement to sublease one of our facilities. The sublease commenced on December 1, 2017, and expired on
November  15,  2019  (which  was  15  days  prior  to  the  expiration  of  the  facility  lease).  Prior  to  December  1,  2018,  the  sublessee  paid  a  base  rent  of  $3.25  per
rentable square foot, or a total of $79,950 per month. On December 1, 2018 the base rent increased to $3.35 per rentable square foot, or a total of $82,410 per
month. In addition to the base rent, the sublessee paid for the Landlord’s operating expenses and property taxes due and payable with respect to the subleased
facility.

We believe that our current facilities are adequate for our current and anticipated future needs through at least 2021.

ITEM 3.    LEGAL PROCEEDINGS

We are not involved in any pending legal proceedings that we believe could have a material adverse effect on our financial condition, results of operations
or cash flows. From time to time we may be involved in legal proceedings or investigations, which could harm our reputation, business and financial condition and
divert the attention of our management from the operation of our business.

ITEM 4.    MINE SAFETY DISCLOSURES

Not applicable.

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ITEM 5.    MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES

Our common stock began trading on the Nasdaq Global Market on January 30, 2015 and was transferred to the Nasdaq Capital Market on January 19,

PART II

2018, where it trades under the symbol “AVGR”.

HOLDERS OF RECORD

As of February 26, 2021 there were 95,298,129 shares of our common stock held by 124 holders of record of our common stock. The actual number of
stockholders is greater than this number of record holders, and includes stockholders who are beneficial owners, but whose shares are held in street name by
brokers and other nominees. This number of holders of record also does not include stockholders whose shares may be held in trust by other entities.

DIVIDEND POLICY

Our Series A preferred stock carries an 8% cumulative dividend, which accumulates and is compounded annually. This cumulative dividend is payable in
arrears  on  December  31  of  each  year,  commencing  with  December  31,  2018,  and  at  our  option  is  payable  in  additional  shares  of  Series  A  preferred  stock.
Additionally,  the  terms  of  our  Series  A  preferred  stock  and  Series  B  preferred  stock  provide  that  we  may  not  declare  dividends  on  the  common  stock  without
concurrently  declaring  dividends  on  such  series  of  preferred  stock  in  an  amount  equal  to  that  payable  had  they  been  converted  to  common  stock  prior  to  the
dividend. We have issued a total of 10,391 shares of Series A preferred stock to pay the preferred dividend to the holder of Series A preferred stock through
December 31, 2020. Other than the preferred dividend on Series A preferred stock, we have never declared or paid any cash dividends on any of our capital
stock. Except with respect to the Series A preferred stock’s cumulative dividend, we do not anticipate paying any dividends in the foreseeable future and currently
intend to retain all available funds and any future earnings for use in the operation of our business and to finance the growth and development of our business.

Future determination as to the declaration and payment of dividends, if any, will be at the discretion of our board of directors and will depend on then
existing  conditions,  including  our  operating  results,  financial  condition,  contractual  restrictions,  capital  requirements,  business  prospects  and  other  factors  our
board  of  directors  may  deem  relevant.  In  addition,  our  Loan  Agreement  with  CRG  prohibits  us  from  paying  any  dividends  or  making  any  other  distribution  or
payment on account of our common stock.

RECENT SALES OF UNREGISTERED SECURITIES

There were no sales of unregistered securities during fiscal 2020 other than those transactions previously reported to the SEC on a Quarterly Report on

Form 10-Q or Current Report on Form 8-K.

PURCHASES OF EQUITY SECURITIES BY THE ISSUER AND AFFILIATED PURCHASERS

None.

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ITEM 6.    SELECTED FINANCIAL DATA

This item does not apply to smaller reporting companies.

ITEM 7.    MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

You  should  read  the  following  discussion  and  analysis  of  our  financial  condition  and  results  of  operations  together  with  our  financial  statements  and
related  notes  included  elsewhere  in  this  Annual  Report  on  Form  10-K.  This  discussion  and  other  parts  of  this  Annual  Report  on  Form   10-K  contain  forward-
looking statements that involve risks and uncertainties, such as statements of our plans, objectives, expectations and intentions, that are based on the beliefs of
our management, as well as assumptions made by, and information currently available to, our management. Our actual results could differ materially from those
discussed in these forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, those discussed in the
section of this Annual Report on Form 10-K entitled “Risk factors.”

Overview

We  are  a  commercial-stage  medical  device  company  that  designs,  manufactures  and  sells  image-guided,  catheter-based  systems  that  are  used  by
physicians to treat patients with peripheral artery disease, or PAD. Patients with PAD have a build-up of plaque in the arteries that supply blood to areas away
from the heart, particularly the pelvis and legs. Our mission is to significantly improve the treatment of vascular disease through the introduction of products based
on our Lumivascular platform, the only intravascular image-guided system available in this market.

We design, manufacture, and sell a suite of products in the United States and select international markets. We are located in Redwood City, California.
Our  current  Lumivascular  platform  consists  of  products  include  our  Lightbox  imaging  console,  the  Ocelot  family  of  catheters,  which  are  designed  to  allow
physicians  to  penetrate  a  total  blockage  in  an  artery,  known  as  a  chronic  total  occlusion,  or  CTO,  and  the  Pantheris  family  of  catheters,  our  image-guided
atherectomy  family  of  catheters  which  is  designed  to  allow  physicians  to  precisely  remove  arterial  plaque  in  PAD  patients.  We  received  CE  Marking  for  our
original Ocelot product in September 2011 and received from the U.S. Food and Drug Administration, or FDA, 510(k) clearance in November 2012. We received
510(k)  clearance  from  the  FDA  for  commercialization  of  Pantheris  in  October  2015.  We  received  an  additional  510(k)  clearance  for  an  enhanced  version  of
Pantheris in March 2016 and commenced sales of Pantheris in the United States and select European countries promptly thereafter. In May 2018, we received
510(k) clearance from the FDA for our current next-generation version of Pantheris. In April 2019, we received 510(k) clearance from the FDA for our Pantheris
SV, a version of Pantheris targeting smaller vessels, and commenced sales in July 2019. The Pantheris SV has a smaller diameter and longer length that we
believe will optimize it for its targeted use.

In  September  2020,  we  received  510(k)  clearance  of  Tigereye,  a  next-generation  CTO  crossing  system  utilizing  Avinger’s  proprietary  image-guided
technology  platform.  Tigereye  is  a  product  line  extension  of  Avinger’s  Ocelot  family  of  image-guided  CTO  crossing  catheters.  Its  design  elements  include  an
upgrade  of  the  image  capture  rate  to  provide  high  definition,  real-time  intravascular  imaging  similar  to  the  company’s  Pantheris  image-guided  atherectomy
system and a user-controlled deflectable tip designed to assist in steerability within the lumen. Tigereye also features a new distal tip configuration with faster
rotational  speeds  designed  to  penetrate  challenging  lesions.  The  Tigereye  catheter  has  a  working  length  of  140  cm  and  5  French  sheath  compatibility  for
treatment  of  lesions  in  the  peripheral  vessels  both  above  and  below  the  knee.  The  product  became  available  in  October  2020  for  first  cases  in  the  U.S  on  a
limited basis and launched commercially in January 2021.

Current  treatments  for  PAD,  including  bypass  surgery,  can  be  costly  and  may  result  in  complications,  high  levels  of  post-surgery  pain,  and  lengthy
hospital stays and recovery times. Minimally invasive, or endovascular, treatments for PAD include stenting, angioplasty, and atherectomy, which is the use of a
catheter-based device for the removal of plaque. These treatments all have limitations in their safety or efficacy profiles and frequently result in recurrence of the
disease,  also  known  as  restenosis.  We  believe  one  of  the  main  contributing  factors  to  high  restenosis  rates  for  PAD  patients  treated  with  endovascular
technologies is the amount of vascular injury that occurs during an intervention. Specifically, these treatments often disrupt the membrane between the outermost
layers of the artery, which is referred to as the external elastic lamina, or EEL.

We believe our Lumivascular platform is the only technology that offers real-time visualization of the inside of the artery during PAD treatment through
the  use  of  optical  coherence  tomography,  or  OCT,  a  high  resolution,  light-based,  radiation-free  imaging  technology.  Our  Lumivascular  platform  provides
physicians with real-time OCT images from the inside of an artery, and we believe Ocelot and Pantheris are the first products to offer intravascular visualization
during CTO crossing and atherectomy, respectively. We believe this approach will significantly improve patient outcomes by providing physicians with a clearer
picture of the artery using radiation-free image guidance during treatment, enabling them to better differentiate between plaque and healthy arterial structures. Our
Lumivascular  platform  is  designed  to  improve  patient  safety  by  enabling  physicians  to  direct  treatment  towards  the  plaque,  while  avoiding  damage  to  healthy
portions of the artery.

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During the first quarter of 2015, we completed enrollment of patients in VISION, a clinical trial designed to support our August 2015 510(k) submission to
the FDA for our Pantheris atherectomy device. VISION was designed to evaluate the safety and efficacy of Pantheris to perform atherectomy using intravascular
imaging  and  successfully  achieved  all  primary  and  secondary  safety  and  efficacy  endpoints.  We  believe  the  data  from  VISION  allows  us  to  demonstrate  that
avoiding damage to healthy arterial structures, and in particular disruption of the external elastic lamina, which is the membrane between the outermost layers of
the artery, reduces the likelihood of restenosis, or re-narrowing, of the diseased artery. Although the original VISION study protocol was not designed to follow
patients beyond six months, we worked with 18 of the VISION sites to re-solicit consent from previous clinical trial patients in order for them to evaluate patient
outcomes through 12 and 24 months following initial treatment. Data collection for the remaining patients from participating sites was completed in May 2017,
and we released the final 12- and 24-month results for a total of 89 patients in July 2017.

During the fourth quarter of 2017, we began enrolling patients in INSIGHT, a clinical trial designed to support a submission to the FDA to expand the
indication  for  our  Pantheris  atherectomy  device  to  include  in-stent  restenosis.  Patient  enrollment  began  in  October  2017  and  is  expected  to  continue  through
2021.  Patient  outcomes  will  be  evaluated  at  thirty  days,  six  months  and  one  year  following  treatment.  We  plan  to  submit  a  510(k)  application  with  the  FDA
seeking a specific indication for treating in-stent restenosis with Pantheris once the trial is fully enrolled and follow-up data through six months are available and
analyzed.

We continue development efforts on the next-generation of the Lightbox imaging console, the Lightbox 3, which is being designed to provide enhanced

real-time video imaging capabilities in a much smaller form factor and at a lower cost. We anticipate filing a 510(k) submission for the Lightbox 3 during 2021.

We  focus  our  direct  sales  force,  marketing  efforts  and  promotional  activities  on  interventional  cardiologists,  vascular  surgeons  and  interventional
radiologists. We also work on developing strong relationships with physicians and hospitals that we have identified as key opinion leaders. Although our sales and
marketing efforts are directed at these physicians because they are the primary users of our technology, we consider the hospitals and medical centers where the
procedure  is  performed  to  be  our  customers,  as  they  typically  are  responsible  for  purchasing  our  products.  We  are  designing  additional  future  products  to  be
compatible  with  our  Lumivascular  platform,  which  we  expect  to  enhance  the  value  proposition  for  hospitals  to  invest  in  our  technology.  Pantheris  qualifies  for
existing reimbursement codes currently utilized by other atherectomy products, further facilitating adoption of our products.

We  have  assembled  a  team  with  extensive  medical  device  development  and  commercialization  experience  in  both  start-up  and  large,  multi-national
medical  device  companies.  We  assemble  all  of  our  products  at  our  manufacturing  facility  but  certain  critical  processes,  such  as  coating  and  sterilization,  are
performed  by  outside  vendors.  We  expect  our  current  manufacturing  facility  in  California,  will  be  sufficient  through  at  least  2021.  We  generated  revenues  of
$7.9  million  in  2018,  $9.1  million  in  2019  and  $8.8  million  in  2020.  The  growth  experienced  in  2019  was  largely  due  to  our  next-generation  Pantheris  and  the
launch of Pantheris SV. The decline in 2020 was primarily due to the adverse effects of COVID-19 on our customers as hospitals deferred elective procedures.

Recent Developments

COVID-19 Update

As a result of the effects of the COVID-19 pandemic, experienced a significant decline in sales in the second quarter of 2020, particularly as individuals,
as well as hospitals and other medical providers, deferred elective procedures in response to COVID-19. Starting in the third quarter of 2020, we experienced a
rebound  of  sales  as  practitioners  began  to  once  again  perform  elective  procedures.  While  certain  jurisdictions  are  easing  restrictions  on  performing  elective
procedures, we cannot be certain that other jurisdictions in the United States will do so in the near future. Furthermore, some jurisdictions have experienced and
continue to experience a resurgence in COVID-19 cases, which has prompted certain hospitals and other medical providers in such areas to again defer elective
procedures  or  further  prolong  or  reinstate  existing  restrictions  on  such  procedures.  If  other  jurisdictions  experience  a  resurgence  in  COVID-19  cases,  these
jurisdictions may also prolong restrictions on elective procedures. This situation has created a significant amount of volatility in the medical industry which makes
future  developments  and  results  difficult  to  predict.  Consequently,  it  is  unclear  whether  any  reduction  in  sales  is  temporary  and  whether  such  sales  may  be
recoverable in the future. In addition to the effects on sales, we have also experienced delays in site initiation and patient enrollment for our clinical studies. If we
are unable to successfully complete these or other clinical studies, our business and results of operations could be harmed.

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We have undertaken and continue to evaluate further action to manage our available cash and other resources to help mitigate the effects of COVID-19
on our business, including by adjusting production to match demand for our products and reducing discretionary costs. During the second quarter of 2020 we
reduced base salaries for all of our non-manufacturing employees by 20% and reduction of hours worked by our manufacturing workers by 20%. While some
measures,  including  salaries  and  hours  worked,  have  returned  to  prior  levels,  we  will  continue  to  employ  certain  actions  to  manage  our  resources  in  the
foreseeable  future.  In  addition,  there  can  be  no  assurance  that  such  strategies  will  be  successful  in  effectively  managing  our  resources  and  mitigating  the
negative impact of the COVID-19 on our business and operating results. In addition, the COVID-19 pandemic and responses thereto have resulted in reduced
consumer and investor confidence, instability in the credit and financial markets, volatile corporate profits, and reduced business and consumer spending, which
could increase the cost of capital and/or limit the availability of capital to the Company in the future.

On March 27, 2020, the President of the United States signed the Coronavirus Aid Relief, and Economic Security (CARES) Act into law. The CARES
Act, among other things, includes provisions relating to refundable payroll tax credits, deferment of employer side social security payments, net operating loss
carryback  periods,  alternative  minimum  tax  credit  refunds,  modifications  to  the  net  interest  deduction  limitations  and  technical  corrections  to  tax  depreciation
methods for qualified improvement property.

We applied for and, on April 23, 2020, received loan proceeds of $2.3 million (the “Loan”) pursuant to the Paycheck Protection Program (“PPP”) under

the CARES Act, (see Financing and Equity below for more details).

On June 5, 2020, the President of the United States signed the Paycheck Protection Program Flexibility Act (the “PPPFA”) into law. The PPPFA gives
borrowers  of  a  PPP  loan  more  flexibility  and  time  to  spend  the  loan  proceeds  and  allows  the  funds  to  be  used  on  broader  categories  of  expenses  while  still
qualifying for loan forgiveness. We applied for forgiveness of the PPP loan during the fourth quarter of 2020. While we believe that we have complied with the
requirements to obtain forgiveness, there can be no assurance that any or all of the PPP loan amount will be forgiven.

We also continue to evaluate and may still pursue additional programs under the CARES Act or other potential legislation, but there is no guarantee that
we will meet any eligibility requirements to participate in such programs or, even if we are able to participate, that such programs will provide meaningful benefit
to our business.

Nasdaq Delisting Notice

As previously reported, on March 10, 2020, Avinger, Inc. (the “Company”) received a letter from the Listing Qualifications Department (the “Staff”) of The
Nasdaq Stock Market, LLC (“Nasdaq”) notifying the Company that the Company was not in compliance with Nasdaq Listing Rule 5550(a)(2) (the “Minimum Bid
Price  Requirement”),  as  the  minimum  bid  price  for  the  Company’s  listed  securities  was  less  than  $1.00  for  the  previous  30  consecutive  business  days.  The
Company initially had a period of 180 calendar days, or until September 8, 2020, to regain compliance with the Minimum Bid Price Requirement.

Also as previously reported, on April 20, 2020, the Company received notification from Nasdaq indicating that Nasdaq filed an immediately effective rule
change with the SEC on April 16, 2020, pursuant to which the compliance periods for bid price and market value of publicly held shares requirements were tolled
through June 30, 2020. As a result, the Company had until November 20, 2020 to regain compliance with Nasdaq’s Minimum Bid Price Requirement.

The  Company  did  not  regain  compliance  with  the  Minimum  Bid  Price  Requirement  by  November  20,  2020.  In  accordance  with  Nasdaq  Listing  Rule
5810(c)(3)(A), the Company provided written notice to Nasdaq of its intent to cure the deficiency and, on November 24, 2020, the Company received notice that
Nasdaq granted the Company an additional 180 calendar days, or until May 19, 2021, to regain compliance.

On January 26, 2021, the Company received a letter from Nasdaq notifying the Company that the Staff had determined that the closing bid price of the
Company’s common stock had been at $1.00 per share or greater for at least 10 consecutive business days and, accordingly, that the Company had regained
compliance with the Minimum Bid Price Requirement for continued listing on the Nasdaq Stock Market and that the matter is now closed. While the Company has
regained  compliance  with  the  Minimum  Bid  Price  Requirement,  there  can  be  no  assurance  that  the  Company  will  be  able  to  maintain  compliance  with  the
Minimum Bid Price Requirement in the future.

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Financing and Equity

On June 19, 2019, the Company’s Board of Directors approved an amendment to the Company’s amended and restated certificate of incorporation to
effect an additional 1-for-10 reverse stock split of the Company’s common stock. The reverse stock split became effective on June 21, 2019. The par value of the
common stock and convertible preferred stock was not adjusted as a result of the reverse stock split. All common stock, stock options, and restricted stock units,
and per share amounts in this document have been retroactively adjusted for all periods presented to give effect to the reverse stock splits.

During the years ended December 31, 2020 and 2019, our net loss and comprehensive loss was $19.0 million and $19.5 million, respectively. We have
not been profitable since inception, and as of December 31, 2020, our accumulated deficit was $367.3 million. Since inception, we have financed our operations
primarily through private and public placements of our preferred and common securities and, to a lesser extent, debt financing arrangements.

In  September  2015,  we  entered  into  a  Term  Loan  Agreement,  or  Loan  Agreement,  with  CRG  Partners  III  L.P.  and  certain  of  its  affiliated  funds,
collectively CRG, under which we were able to borrow up to $50.0 million on or before March 29, 2017, subject to certain terms and conditions. We borrowed
$30.0 million on September 22, 2015 and an additional $10.0 million on June 15, 2016 under the Loan Agreement. Contemporaneously with the execution of the
Loan  Agreement,  we  entered  into  a  Securities  Purchase  Agreement  with  CRG,  pursuant  to  which  CRG  purchased  870  shares  of  our  common  stock  on
September 22, 2015 at a price of $5,596.40 per share, which represents the 10-day average of closing prices of our common stock ending on September 21,
2015.  Pursuant  to  the  Securities  Purchase  Agreement,  we  filed  a  registration  statement  covering  the  resale  of  the  shares  sold  to  CRG  and  must  comply  with
certain affirmative covenants during the time that such registration statement remains in effect.

On  February  14,  2018,  we  entered  into  a  Series  A  preferred  stock  Purchase  Agreement  (the  “Series  A  Purchase  Agreement”)  with  CRG,  pursuant  to
which  it  agreed  to  convert  $38.0  million  of  the  outstanding  principal  amount  of  its  senior  secured  term  loan  (plus  the  back-end  fee  and  prepayment  premium
applicable thereto) under the Loan Agreement into a newly authorized Series A preferred stock. As discussed in the section of this report titled “Dividend Policy,”
the holders of Series A preferred stock are entitled to receive annual accruing dividends at a rate of 8%, payable in additional shares of Series A preferred stock
or cash, at our option. The shares of Series A preferred stock have no voting rights and rank senior to all other classes and series of the Company’s equity in
terms of repayment and certain other rights.

We entered into several amendments to the Term Loan Agreement (the “Amendments”) with CRG since September 2015, the most recent of which, was
completed on January 22, 2021. The Amendments terms, among other things: (1) extended the interest-only period through December 31, 2023; (2) extended
the period during which the Company may elect to pay a portion of interest in payment-in-kind, or PIK, interest payments through December 31, 2023 so long as
no default has occurred and is continuing; (3) permitted the Company to make its entire interest payments in PIK interest payments for through December 31,
2023 so long as no default has occurred and is continuing; (4) extended the maturity date to December 31, 2025; (5) reduced the minimum liquidity requirement
to $3.5 million at all times; (6) eliminated the minimum revenue covenant for 2018, 2019 and 2020; (7) reduced the minimum revenue covenant to $8 million for
2021, $10 million for 2022; (8) added minimum revenue covenants for of $12 million for 2023, $14.5 million for 2024 and $17 million for 2025; (9) changed the
date  under  the  on-going  stand-alone  representation  regarding  no  “Material  Adverse  Change”  to  December  31,  2020;  (10)  amended  the  on-going  stand-alone
representation and stand-alone event of default regarding Material Adverse Change such that any adverse change in or effect upon the revenue of the Company
and its subsidiaries due to the outbreak of COVID-19 will not constitute a Material Adverse Change; and (11) provided CRG with board observer rights. 

On  March  2,  2020,  we  entered  into  Amendment  No.  3  to  the  Term  Loan  Agreement  (the  “Amendment  No.  3  Loan  Agreement”)  with  CRG.  Under  its
terms,  the  Amendment  No.  3  Loan  Agreement,  among  other  things:  (1)  extended  the  period  during  which  the  Company  may  elect  to  pay  its  entire  interest
payments in PIK interest payments through June 30, 2021; and (2) reduced the minimum revenue covenants to $10 million for 2020, $12 million for 2021, and $15
million for 2022. On May 12, 202, we entered into Amendment No. 4 to the Term Loan Agreement (the “Amendment No. 4 Loan Agreement”) with CRG which,
among other things, waived the Company’s requirement to comply with the minimum revenue covenant for 2020.

On March 7, 2019, we filed a universal shelf registration statement (the “Shelf Registration Statement”) to offer up to $50.0 million of our securities. We
have established, and may in the future establish, “at-the-market” programs pursuant to which we may offer and sell shares of our common stock pursuant to the
Shelf Registration Statement. Under the Shelf Registration Statement, on August 26, 2019, we completed a public offering of 3,813,559 shares of common stock
at an offering price of $1.18 per share. As a result, we received net proceeds of approximately $3.8 million after underwriting discounts, commissions, legal and
accounting fees and the conversion price of the outstanding shares of Series B preferred stock, issued in our February 2018 offering, was reduced to $1.18 per
share as a result.

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On  January  31,  2020,  we  completed  a  public  offering  of  6,428,572  shares  of  common  stock  at  an  offering  price  of  $0.70  per  share.  As  a  result,  we
received net proceeds of approximately $3.9 million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses. Due to
anti-dilution provisions, the conversion price of the outstanding shares of Series B preferred stock, which was issued in our February 2018 offering, was reduced
to $0.70 per share.

On April 23, 2020, we received loan proceeds of $2.3 million pursuant to the Paycheck Protection Program under the CARES Act. The Loan, which was
in the form of a promissory note, dated April 20, 2020, between the Company and Silicon Valley Bank as the lender, matures on April 20, 2022 and bears interest
at a fixed rate of 1% per annum, payable monthly commencing in six months. Under the terms of the PPP and the PPPFA, the principal may be forgiven if the
Loan  proceeds  are  used  for  qualifying  expenses  as  described  in  the  CARES  Act,  such  as  payroll  costs,  benefits  mortgage  interest,  rent,  and  utilities.  No
assurance can be provided that the Company will obtain forgiveness of the Loan in whole or in part. The Company may be required to repay some or all of the
Loan due to changes or different interpretations of the PPP requirements that continue to evolve.

The  Promissory  Note  evidencing  the  PPP  Loan  contains  customary  representations,  warranties,  and  covenants  for  this  type  of  transaction,  including
customary  events  of  default  relating  to,  among  other  things,  payment  defaults  and  breaches  of  representations  and  warranties  or  other  provisions  of  the
Promissory Note. The occurrence of an event of default may result in, among other things, the Company becoming obligated to repay all amounts outstanding.
We continue to evaluate and may still apply for additional programs under the CARES Act, there is no guarantee that we will meet any eligibility requirements to
participate in such programs or, even if we are able to participate, that such programs will provide meaningful benefit to our business.

On April 30, 2020, we completed a public offering of 12,600,000 shares of common stock at an offering price of $0.25 per share. On May 6, 2020 we
issued an additional 1,890,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection  with  the  aforementioned  offering.  As  a  result,  we  received  aggregate  net  proceeds  of  approximately  $3.0  million  after  underwriting  discounts,
commissions, legal and accounting fees, and other ancillary expenses. Due to anti-dilution provisions, the conversion price of the outstanding shares of Series B
preferred stock, which was issued in our February 2018 offering, was reduced to $0.25 per share.

On June 26, 2020, we completed a public offering of 20,000,000 shares of common stock at an offering price of $0.27 per share. On July 9, 2020 we
issued an additional 3,000,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection with the aforementioned offering resulting in $0.7 million of additional net proceeds. As a result, we received aggregate net proceeds of approximately
$5.5 million including the overallotment option and after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 6, 2020, under the Shelf Registration Statement, we completed a public offering of 15,789,474 shares of common stock at an offering price of
$0.38 per share. On August 11, 2020 we issued an additional 2,368,421 shares of common stock at the same offering price pursuant to the exercise in full of the
underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $6.2 million
after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 25, 2020, under the Shelf Registration Statement, we completed a public offering of 11,063,830 shares of common stock at an offering price
of $0.47 per share. On September 1, 2020 we issued an additional 1,000,000 shares of common stock at the same offering price pursuant to the exercise in full
of the underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $5.1
million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On February 2, 2021, under the Shelf Registration Statement, we completed a bought deal offering of 10,000,000 shares of common stock at an offering
price of $1.44 per share. As a result, we received aggregate net proceeds of approximately $13.0 million after underwriting discounts, commissions, legal and
accounting fees, and other ancillary expenses.

54

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
Components of our Results of Operations

Revenues

All  of  our  revenues  are  currently  derived  from  sales  of  our  various  PAD  catheters  in  the  United  States  and  select  international  markets,  Lightbox
consoles,  as  well  as  related  services.  We  expect  our  revenues  to  increase  in  2021  due  to  the  availability  of  our  Tigereye  launch  in  late  2020  and  easing  of
restrictions  on  elective  procedures  due  to  the  diminishing  impact  of  COVID-19.  No  single  customer  accounted  for  more  than  10%  of  our  revenues  during  the
years ended December 31, 2020 and 2019.

Revenues may fluctuate from quarter to quarter due to a variety of factors including capital equipment purchasing patterns that are typically increased
towards the end of the calendar year and decreased in the first quarter. In addition, during the first quarter, our results can be harmed by adverse weather and by
resetting of annual patient healthcare insurance plan deductibles, both of which may cause patients to delay elective procedures. In the third quarter, the number
of elective procedures nationwide is historically lower than other quarters throughout the year, which we believe is primarily attributable to the summer vacations
of physicians and their patients.

Cost of Revenues and Gross Margin

Cost of revenues consists primarily of costs related to manufacturing overhead, materials and direct labor. We expense all warranty costs and inventory
provisions as cost of revenues. We periodically write-down inventory for estimated excess, obsolete and non-sellable inventories based on assumptions about
future demand, past usage, changes to manufacturing processes and overall market conditions. A significant portion of our cost of revenues currently consists of
manufacturing  overhead  costs.  These  overhead  costs  include  the  cost  of  quality  assurance,  material  procurement,  inventory  control,  facilities,  equipment  and
operations supervision and management. We expect overhead costs as a percentage of revenues to become less significant as our production volume increases.
Cost  of  revenues  also  includes  depreciation  expense  for  production  equipment,  depreciation  and  related  maintenance  expense  for  placed  Lightboxes  held  by
customers and certain direct costs such as those incurred for shipping our products.

We  calculate  gross  margin  as  gross  profit  divided  by  revenues.  Our  gross  margin  has  been  and  will  continue  to  be  affected  by  a  variety  of  factors,
primarily  production  volumes,  manufacturing  costs,  product  yields,  headcount,  charges  for  excess  and  obsolete  inventories  and  cost-reduction  strategies.  We
intend to use our design, engineering and manufacturing capabilities to further advance and improve the efficiency of our manufacturing processes, which we
believe will reduce costs and increase our gross margin. In the future, we may seek to manufacture certain of our products outside the United States to further
reduce costs. Our gross margin will likely fluctuate from quarter to quarter as we continue to introduce new products and sales channels, and as we adopt new
manufacturing processes and technologies.

Research and Development Expenses

Research and development, or R&D, expenses consist primarily of engineering, product development, clinical and regulatory affairs, consulting services,
materials, depreciation and other costs associated with products and technologies in development. These expenses include employee compensation, including
stock-based  compensation,  supplies,  materials,  quality  assurance  expenses  allocated  to  R&D  programs,  consulting,  related  travel  expenses  and  facilities
expenses. Clinical expenses include clinical trial design, clinical site reimbursement, data management, travel expenses and the cost of manufacturing products
for clinical trials. We expect R&D expenses to vary over time depending on the level and timing of our new product development efforts, as well as our clinical
development, clinical trial and other related activities.

Selling, General and Administrative Expenses

Selling, general and administrative, or SG&A, expenses consist primarily of compensation for personnel, including stock-based compensation, selling and
marketing  functions,  physician  education  programs,  business  development,  finance,  information  technology  and  human  resource  functions.  Other  SG&A
expenses include commissions, training, travel expenses, educational and promotional activities, marketing initiatives, market research and analysis, conferences
and trade shows, professional services fees, including legal, audit and tax fees, insurance costs and general corporate expenses. We expect SG&A expenses to
increase as we expand our commercial efforts whilst navigating through the effects of COVID-19.

Interest Expense, net

Interest  expense,  net  consists  primarily  of  interest  incurred  on  our  outstanding  indebtedness  and  non-cash  interest  related  to  the  amortization  of  debt

discount and issuance costs associated with our various debt agreements.

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Other Income, net

Other  income,  net  primarily  consists  of  gains  and  losses  resulting  from  the  remeasurement  of  foreign  exchange  transactions  and  in  2019,  sublease

income.

Results of Operations:

Revenues
Cost of revenues
Gross profit
Gross margin

Operating expenses:

Research and development
Selling, general and administrative

Total operating expenses

Loss from operations
Interest expense, net
Other income, net

Net loss and comprehensive loss

Year Ended December 31,

2020

2019

  $

  $

  $

8,761 
6,143 
2,618 

30%   

5,695 
14,327 
20,022 
(17,404)    
(1,658)    
56 
(19,006)   $

9,131 
6,264 
2,867 

31%

5,692 
16,534 
22,226 
(19,359)
(1,192)
1,101 
(19,450)

Comparison of Years Ended December 31, 2020 and 2019

Revenues. Revenues  decreased  $0.4  million,  or  4%,  to  $8.8  million  during  the  year  ended  December  31,  2020.  The  decrease  reflects  the  effects  of
COVID-19 prompting hospitals and other medical providers to defer elective procedures. This decline was partially offset by increases in revenue from sales of
Pantheris SV product, which was released commercially in July 2019.

Cost of Revenues and Gross Margin.  Cost of revenues decreased $0.1 million, or 2%, to $6.1 million during the year ended December 31, 2020. This

decrease was primarily attributable to the decrease in revenues for the same period.

Gross margin for the year ended December 31, 2020 decreased to 30% compared to 31% in the prior year. The decrease in gross margin was primarily
a result of the decline in revenues due to COVID-19 and higher excess and obsolete charges on inventory. Stock-based compensation expense within cost of
revenues totaled $0.1 million for both the years ended December 31, 2020 and 2019, respectively.

Research  and  Development  Expenses.   R&D  expenses  remained  flat  in  comparison  to  the  year  ended  December  31,  2019.  We  experienced  higher
project  spending  for  next  generation  products,  including  the  Lightbox  3  imaging  console,  offset  by  decreases  in  compensation  expense.  Stock-based
compensation expense within R&D totaled $0.5 million for both the years ended December 31, 2020 and 2019.

Selling, General and Administrative Expenses.  SG&A expenses decreased $2.2 million, or 13%, to $14.3 million during the year ended December 31,
2020. This decrease was primarily due to a decrease in compensation costs resulting from expense reduction measures, decreased variable compensation and
lower stock-based compensation. Stock-based compensation expense within SG&A totaled $0.9 million and $1.4 million for the years ended December 31, 2020
and 2019, respectively.

Interest Expense, net.  Interest expense, net increased $0.5 million, or 39%, to a net expense of $1.7 million during the year ended December 31, 2020.
The increase was primarily due to the higher CRG loan balance from interest being compounded and lower interest income as compared to the prior year period,
due to the decline in the money market interest rates during the period.

Other  income,  net.  Other  income,  net  primarily  consists  of  gains  and  losses  resulting  from  the  remeasurement  of  foreign  exchange  transactions  and
other miscellaneous income and expenses. During the year ended December 31, 2019, this also consisted of sublease income. Our subleasing arrangement of a
portion  of  the  Company’s  facilities  was  concluded  during  2019.  Consequently,  the  year  ended  December  31,  2020  consisted  only  of  net  gains  due  to
remeasurement of foreign exchange transactions resulting in a decrease of approximately $1.0 million or 95%.

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Liquidity and Capital Resources

As of December 31, 2020, we had cash and cash equivalents of $22.2 million and an accumulated deficit of $367.3 million, compared to cash and cash
equivalents of $10.9 million and an accumulated deficit of $348.3 million as of December 31, 2019. The Company expects to incur losses for the foreseeable
future.  The  Company  believes  that  its  cash  and  cash  equivalents  of  $22.2  million  at  December  31,  2020,  together  with  the  approximately  $13.0  million  net
proceeds from the February 2021 equity financing (see Equity Financings below), and expected revenues, debt and financing activities and funds from operations
will be sufficient to allow the Company to fund its current operations through 2022. We do not know when or if our operations will generate sufficient cash to fund
our  ongoing  operations.  Additional  debt  financing,  if  available,  may  involve  covenants  restricting  our  operations  or  our  ability  to  incur  additional  debt.  Any
additional debt financing or additional equity that we raise may contain terms that are not favorable to us or our stockholders and require significant debt service
payments,  which  divert  resources  from  other  activities.  Additional  financing  may  not  be  available  at  all,  or  if  available,  may  not  be  in  amounts  or  on  terms
acceptable to us. If we are unable to obtain additional financing, we may be required to delay the development, commercialization and marketing of our products
and we may be required to significantly scale back our business and operations.

In  addition,  the  COVID-19  pandemic  and  responses  thereto  have  resulted  in  reduced  consumer  and  investor  confidence,  instability  in  the  credit  and
financial markets, volatile corporate profits, restrictions on elective medical procedures, and reduced business and consumer spending, which could increase the
cost of capital and/or limit the availability of capital to the Company. While we have taken certain actions to manage our available cash and other resources to
mitigate  the  effects  of  COVID-19  on  our  business,  there  can  be  no  assurance  that  such  strategies  will  be  successful  in  mitigating  the  negative  impacts  of  the
COVID-19 pandemic on our liquidity and capital resources.

To  date,  we  have  financed  our  operations  primarily  through  net  proceeds  from  the  issuance  of  our  preferred  stock  and  debt  financings,  our  “at-the-
market” program, our initial public offering, or IPO, our follow-on public offerings and warrant issuances. The warrants issued pursuant to the Series B Purchase
Agreement  entered  into  in  connection  with  the  Series  B  preferred  stock  follow-on  in  February  2018,  or  the  Series  B  Offering,  prohibited  us  from  entering  into
certain  transactions  involving  the  issuance  of  securities  for  a  price  determined  by  reference  to  the  trading  price  of  our  common  stock  or  otherwise  subject  to
modification  following  the  date  of  issuance,  in  each  case  for  a  period  of  three  years  from  the  closing  date  of  the  Series  B  Offering  (and  excluding  purchases
pursuant to the Series B Purchase Agreement, which may be made on the 120 day anniversary of the closing date of the offering).

Equity Financings

On March 7, 2019, we filed a universal shelf registration statement (the “Shelf Registration Statement”) to offer up to $50.0 million of our securities. We
have established, and may in the future establish, “at-the-market” programs pursuant to which we may offer and sell shares of our common stock pursuant to the
Shelf Registration Statement. Due to the SEC’s “baby shelf rules,” which prohibit companies with a public float of less than $75 million from issuing securities
under a shelf registration statement in excess of one-third of such company’s public float in a twelve-month period, we are only able to issue a limited number of
shares  using  the  Shelf  Registration  Statement  at  this  time.  Under  the  Shelf  Registration  Statement,  on  August  26,  2019,  we  completed  a  public  offering  of
3,813,559 shares of common stock at an offering price of $1.18 per share. As a result, we received net proceeds of approximately $3.8 million after underwriting
discounts, commissions, legal and accounting fees. Due to anti-dilution provisions, the conversion price of the outstanding shares of Series B preferred stock,
which was issued in our February 2018 offering, was reduced to $1.18 per share.

During the year ended December 31, 2019, we received proceeds of approximately $8.0 million from the issuance of 1,998,079 shares of common stock

related to warrant exercises associated with the Series C preferred stock.

On  January  31,  2020,  we  completed  a  public  offering  of  6,428,572  shares  of  common  stock  at  an  offering  price  of  $0.70  per  share.  As  a  result,  we
received net proceeds of approximately $3.9 million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses. Due to
anti-dilution provisions, the conversion price of the outstanding shares of Series B preferred stock, which was issued in our February 2018 offering, was reduced
to $0.70 per share.

On April 30, 2020, we completed a public offering of 12,600,000 shares of common stock at an offering price of $0.25 per share. On May 6, 2020 we
issued an additional 1,890,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection  with  the  aforementioned  offering.  As  a  result,  we  received  aggregate  net  proceeds  of  approximately  $3.0  million  after  underwriting  discounts,
commissions, legal and accounting fees, and other ancillary expenses. Due to anti-dilution provisions, the conversion price of the outstanding shares of Series B
preferred stock, which was issued in our February 2018 offering, was reduced to $0.25 per share.

57

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On June 26, 2020, we completed a public offering of 20,000,000 shares of common stock at an offering price of $0.27 per share. On July 9, 2020 we
issued an additional 3,000,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection with the aforementioned offering resulting in $0.7 million of additional net proceeds. As a result, we received aggregate net proceeds of approximately
$5.5 million including the overallotment option and after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 6, 2020, under the Shelf Registration Statement, we completed a public offering of 15,789,474 shares of common stock at an offering price of
$0.38 per share. On August 11, 2020 we issued an additional 2,368,421 shares of common stock at the same offering price pursuant to the exercise in full of the
underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $6.2 million
after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 25, 2020, under the Shelf Registration Statement, we completed a public offering of 11,063,830 shares of common stock at an offering price
of $0.47 per share. On September 1, 2020 we issued an additional 1,000,000 shares of common stock at the same offering price pursuant to the exercise in full
of the underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $5.1
million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On February 2, 2021, under the Shelf Registration Statement, we completed a bought deal offering of 10,000,000 shares of common stock at an offering
price of $1.44 per share. As a result, we received aggregate net proceeds of approximately $13.0 million after underwriting discounts, commissions, legal and
accounting fees, and other ancillary expenses.

CRG Loan

On  March  2,  2020,  the  Company  and  CRG  further  amended  the  Loan  Agreement  to  change  the  date  upon  which  cash  payments  for  interest  will
commence  from  the  first  quarter  of  2020  to  the  third  quarter  of  2021.  No  cash  payments  for  principal  will  be  made  until  the  final  two  years  of  the  loan,  which
matures  in  June  2023.  On  May  12,  2020,  the  Company  and  CRG  entered  into  another  amendment  to  waive  the  Company’s  requirement  to  comply  with  the
minimum required revenue covenant for 2020 and granted to Company the ability to optionally prepay in whole or in part the outstanding principal amount of the
Loans for the Redemption Price. The total CRG Loan amount, shown as borrowings on the balance sheet as of December 31, 2020, is $10.6 million. However,
upon  maturity  of  the  debt  in  December  2025,  the  Company  will  be  obligated  to  pay  $19.4  million  under  the  CRG  Loan,  which  includes  future  interest  to  be
accrued  but  not  paid  in  cash  as  well  as  a  $2.2  million  back-end  fee  which  is  being  accreted  to  the  maturity  date.  Refer  to  Item  8,  Financial  Statements  and
Supplementary Data, Footnote 13 for additional details.

PPP Loan

On April 23, 2020, we received loan proceeds of $2.3 million pursuant to the Paycheck Protection Program under the CARES Act. The Loan, which was
in the form of a promissory note, dated April 20, 2020, between the Company and Silicon Valley Bank as the lender, matures on April 20, 2022 and bears interest
at a fixed rate of 1% per annum, payable monthly commencing one month after the Small Business Association (“SBA”) delivers conclusions on the amount of
the loan to be forgiven. The conclusion from the SBA will be delivered once an audit of our application for forgiveness along with ancillary materials provided has
been completed. Under the terms of the PPP, the principal may be forgiven if the Loan proceeds are used for qualifying expenses as described in the CARES
Act and the PPPFA, such as payroll costs, benefits mortgage interest, rent, and utilities. No assurance can be provided that the Company will obtain forgiveness
of the Loan in whole or in part. In addition, details of the PPP continue to evolve regarding which companies are qualified to receive loans pursuant to the PPP
and  on  what  terms,  and  the  Company  may  be  required  to  repay  some  or  all  of  the  Loan  due  to  these  changes  or  different  interpretations  of  the  PPP
requirements. We submitted our application for forgiveness to the SBA in December 2020.

The  Promissory  Note  evidencing  the  PPP  Loan  contains  customary  representations,  warranties,  and  covenants  for  this  type  of  transaction,  including
customary  events  of  default  relating  to,  among  other  things,  payment  defaults  and  breaches  of  representations  and  warranties  or  other  provisions  of  the
Promissory Note. The occurrence of an event of default may result in, among other things, the Company becoming obligated to repay all amounts outstanding.
We continue to evaluate and may still apply for additional programs under the CARES Act or other legislation passed into law from time to time, however, there is
no guarantee that we will meet any eligibility requirements to participate in such programs or, even if we are able to participate, that such programs will provide
meaningful benefit to our business.

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Cash Flows

Net cash (used in) provided by:

Operating activities
Investing activities
Financing activities

Net increase (decrease) in cash and cash equivalents

Net Cash Used in Operating Activities

Year Ended December 31,

2020

2019

  $

  $

(14,835)   $
65     
26,012     
11,242    $

(17,264)
(70)
11,867 
(5,467)

Net cash used in operating activities for the year ended December 31, 2020 was $14.8 million, consisting primarily of a net loss of $19.0 million and an
increase  in  net  operating  assets  of  approximately  $0.6  million,  partially  offset  by  non-cash  charges  of  $4.7  million.  Non-cash  charges  largely  related  to  stock-
based compensation of $1.5 million, non-cash interest expense and other charges of $1.5 million, depreciation and amortization of $0.9 million and provisions for
excess  and  obsolete  inventory  of  $0.5  million.  The  increase  in  net  operating  assets  was  primarily  due  to  the  increase  in  inventory  and  a  decrease  in  accrued
compensation.

Net cash used in operating activities for the year ended December 31, 2019 was $17.3 million, consisted primarily of a net loss of $19.5 million and an
increase in net operating assets of $2.0 million, offset by non-cash charges of $4.2 million. Non-cash charges largely related to stock-based compensation of $2.1
million,  non-cash  interest  expense  of  $1.3  million,  and  depreciation  and  amortization  of  $0.9  million.  The  increase  in  net  operating  assets  was  primarily  due
to decreases in accounts payable and accrued expenses and other current liabilities and increases in inventory and accounts receivable; partially offset by an
increase in accrued compensation.

Net Cash Provided by (Used in) Investing Activities

Net cash provided by investing activities during the year ended December 31, 2020 was $65,000 consisting of proceeds from the sale of property and

equipment.

Net  cash  used  in  investing  activities  during  the  year  ended  December  31,  2019  was  $70,000  consisting  of  purchases  of  property  and  equipment  of

$88,000, partially offset by proceeds from the sale of property and equipment.

Net Cash Provided by Financing Activities

Net  cash  provided  by  financing  activities  in  the  year  ended  December  31,  2020  of  $26.0  million  primarily  relates  to  23.6  million  of  proceeds  from  the
issuance  of  common  stock  in  our  public  offerings,  net  of  various  issuance  costs  and  proceeds  of  $2.3  million  from  borrowings  pursuant  to  the  PPP  under  the
CARES Act.

Net cash provided by financing activities in the year ended December 31, 2019 of $11.9 million primarily related to proceeds of $8.0 million from warrant

exercises and net proceeds of $3.8 million from the issuance of common stock in a public offering, net of various issuance costs.

Off-Balance Sheet Arrangements

We currently have no off-balance sheet arrangements, such as structured finance, special purpose entities, or variable interest entities.

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Contractual Obligations

Our  principal  obligations  consist  of  the  operating  lease  for  our  facilities,  our  Loan  Agreement  with  CRG,  our  PPP  Loan  and  non-cancelable  purchase

commitments. The following table sets out, as of December 31, 2020, our contractual obligations due by period (in thousands):

Operating lease obligations
CRG Loan
PPP Loan
Noncancellable purchase commitments

Payments Due by Period

Within
1 Year

2 - 3
Years

4-5 Years

  $

  $

1,123    $
—     
1,692     
171     
2,986    $

2,365    $
—     
673     
—     
3,038    $

1,138    $
19,383     
—     
—     
20,521    $

More
Than 5
Years

Total

4,626 
19,383 
2,365 
171 
26,545 

—    $
—     
—     
—     
—    $

The  total  CRG  Loan  amount,  shown  as  borrowings  on  the  balance  sheet  as  of  December  31,  2020,  is  $10.6  million.  The  contractual  obligation  in  the
table  above  of  $19.4  million  under  the  CRG  Loan  takes  the  most  recent  amendment  into  account  when  determining  future  obligations  which  includes  future
interest to be accrued but not paid in cash as well as a $2.2 million back-end fee to be paid in December 2025 upon maturity of the CRG Loan which is being
accreted. Refer to Item 8, Financial Statements and Supplementary Data, Footnote 13 for details.

Under the terms of the PPP, the principal may be forgiven if the Loan proceeds are used for qualifying expenses as described in the CARES Act and the
PPPFA, such as payroll costs, benefits mortgage interest, rent, and utilities. No assurance can be provided that the Company will obtain forgiveness of the Loan
in whole or in part.

CRG

For more information, see Part II, Item 7 “Liquidity and Capital Resources.”

Lease Agreements

Through November 30, 2019, we maintained our principal executive offices, comprising 44,200 square feet in two buildings in Redwood City, California,
under a lease agreement that was originally to expire in November 2019. On April 1, 2019, we entered into an amendment to the lease which extended the lease
term for an additional period of five years subsequent to the original expiration of November 30, 2019. As amended, the lease will expire on November 30, 2024.
Under the terms of the amendment, we are obligated to pay approximately $5.8 million in base rent payments through November 2024, beginning on December
1, 2019. Our facility houses our research and development, sales, marketing, manufacturing, finance and administrative activities.

On October 19, 2017, we entered into an agreement to sublease one of our facilities. The sublease commenced on December 1, 2017, and expired on
November 15, 2019 (which was 15 days prior to the expiration of the facility lease). In addition to the base rent, the sublessee paid for the Landlord’s operating
expenses and property taxes due and payable with respect to the subleased facility. We recorded $1.1 million of sublease payments received in other income on
the statement of operations and comprehensive loss for the year ended December 31, 2019.

Critical Accounting Policies and Estimates

Management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been prepared
in accordance with U.S. generally accepted accounting principles. The preparation of these financial statements requires us to make estimates and assumptions
for the reported amounts of assets, liabilities, revenues, expenses and related disclosures. Our estimates are based on our historical experience and on various
other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets
and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions and any
such differences may be material.

While our significant accounting policies are more fully described in Note 2 of our financial statements included in this Annual Report on Form 10-K, we
believe the following discussion addresses our most critical accounting policies, which are those that are most important to our financial condition and results of
operations and require our most difficult, subjective and complex judgments. 

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Revenue Recognition

The Company’s revenues are derived from (1) sale of Lightbox consoles, (2) sale of disposables, which consist of catheters and accessories, and (3) sale
of  customer  service  contracts  and  maintenance.  The  Company  sells  its  products  directly  to  hospitals  and  medical  centers  as  well  as  through  distributors.  The
Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties
are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company’s revenues are measured based
on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government
authorities. For all sales, the Company uses either a signed agreement or a binding purchase order as evidence of an arrangement. The Company’s revenue
recognition policies generally result in revenue recognition at the following points:

1.

2.

3.

Lightbox console sales: Provided all other criteria for revenue recognition have been met, the Company recognizes revenue for Lightbox console
sales directly to end customers when delivery and acceptance occurs, which is defined as receipt by the Company of an executed form that the
installation process is complete.

Sales of disposables: Disposable revenues consist of sales of the Company’s catheters and accessories and are recognized when the product
has shipped, risk of loss and title has passed to the customer and collectability is reasonably assured.

Service  revenue:  Service  contract  revenue  consists  of  preventative  maintenance,  upgrades,  and  service  contracts.  Service  contracts  are
recognized ratably over the term of the service period and maintenance contract revenue is recognized as work is performed. To date, service
revenue has been insignificant.

The Company offers its customers the ability to purchase or lease the Lightbox console. In addition, the Company provides a Lightbox under a limited
commercial evaluation program to allow accounts to install and utilize the Lightbox for a limited trial period. When a Lightbox is placed under a lease agreement or
under  a  commercial  evaluation  program,  the  Company  retains  title  to  the  equipment  and  it  remains  capitalized  on  its  balance  sheet  under  property  and
equipment.  Depreciation  expense  on  these  placed  Lightboxes  is  recorded  to  cost  of  revenues  on  a  straight-line  basis.  The  costs  to  maintain  these  placed
Lightboxes are charged to cost of revenues as incurred.

The Company evaluates its lease and commercial evaluation program agreements and accounts for these contracts under the guidance in Accounting
Standards Codification (“ASC”) 842, Leases and ASU No. 2014 09,  Revenue from Contracts with Customers (Topic 606) . The guidance requires arrangement
consideration to be allocated between a lease deliverable and a non-lease deliverable based upon the relative selling-price of the deliverables.

The Company assessed whether the embedded lease is an operating lease or sales-type lease. Based on the Company’s assessment of the guidance
and given that any payments under the lease agreements are dependent upon contingent future sales, it was determined that collectability of the minimum lease
payments is not reasonably predictable. Accordingly, the Company concluded the embedded lease did not meet the criteria of a sales-type lease and accounts
for  it  as  an  operating  lease.  The  Company  recognizes  revenue  allocated  to  the  lease  as  the  contingent  disposable  product  purchases  are  delivered  and  are
included in revenues within the statement of operations and comprehensive loss.

For  sales  through  distributors,  the  Company  recognizes  revenue  when  control  of  the  product  transfers  from  the  Company  to  the  distributor.  The
distributors  are  responsible  for  all  marketing,  sales,  training  and  warranty  in  their  respective  territories.  The  standard  terms  and  conditions  contained  in  the
Company’s distribution agreements do not provide price protection or stock rotation rights to any of its distributors. In addition, its distributor agreements do not
allow the distributor to return or exchange products, and the distributor is obligated to pay the Company upon invoice regardless of its ability to resell the product.

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Inventories

Inventories are valued at the lower of cost or net realizable value. Cost is determined using the first-in, first-out method for all inventories. The Company’s
policy is to write down inventory that has expired or become obsolete, inventory that has a cost basis in excess of its expected net realizable value, and inventory
in excess of expected requirements. At each balance sheet date, management evaluates inventories for excess quantities, and obsolescence. This evaluation by
management  includes  analysis  of  historical  sales  levels  by  product,  projections  of  future  demand,  the  risk  of  technological  or  competitive  obsolescence  for
products, general market conditions, as well as the feasibility of reworking or using excess or obsolete products or components in the production or assembly of
other products that are not obsolete or for which there are not excess quantities in inventory. To the extent that management determines there are excess or
obsolete inventory, management adjusts the carrying value to estimated net realizable value. When quantities on hand exceed sales forecasts, a write-down is
recorded for such excess inventories with a corresponding charge to cost of revenues. The estimate of excess quantities is subjective and primarily dependent on
the estimates of future demand for a particular product. Changes in assumptions of product demand could have a significant impact on the amount of write-down
recorded. Inventory used in clinical trials is expensed at the time of production and recorded as research and development expense.

Stock-Based Compensation

Stock-based compensation for the Company includes amortization related to all stock options and restricted stock units (“RSUs”), based on the grant-
date  estimated  fair  value.  The  fair  value  of  stock  options  is  estimated  on  the  date  of  grant  using  the  Black-Scholes  option  pricing  model  and  recognized  as
expense on a straight-line basis over the vesting period of the award. The Company measures the fair value of RSUs using the closing stock price of a share of
the Company’s common stock on the grant date and is recognized as expense on a straight-line basis over the vesting period of the award. As allowed under
ASU No. 2016‑09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting, we account for forfeitures as
they occur.

ITEM 7A.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

Interest Rate Risk

The risk associated with fluctuating interest rates is primarily limited to our cash equivalents, which are carried at quoted market prices. Due to the short-
term maturities and low risk profile of our cash equivalents, an immediate 100 basis point change in interest rates would not have a material effect on the fair
value of our cash equivalents. We do not currently use or plan to use financial derivatives in our investment portfolio.

Credit Risk

As of December 31, 2020, our cash and cash equivalents were maintained with one financial institution in the United States, and our current deposits are
likely  in  excess  of  insured  limits.  We  have  reviewed  the  financial  statements  of  this  institution  and  believe  it  has  sufficient  assets  and  liquidity  to  conduct  its
operations in the ordinary course of business with little or no credit risk to us.

Our accounts receivable primarily relate to revenues from the sale of our Lumivascular platform products to hospitals and medical centers in the United
States.  One  customer  represented  14%  of  our  accounts  receivable  as  of  December  31,  2020.  None  of  our  customers  represented  more  than  10%  of  our
accounts receivable as of December 31, 2019.

Foreign Currency Risk

Our business is primarily conducted in U.S. dollars. Any transactions that may be conducted in foreign currencies are not expected to have a material

effect on our results of operations, financial position or cash flows.

ITEM 8.    FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

The information required by this item appears in a separate section of this Annual Report on Form 10-K beginning on page F-1 and is incorporated herein

by reference.

ITEM 9.    CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE

There were no disagreements with Moss Adams LLP.

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ITEM 9A.    CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our reports under the Securities
Exchange Act of 1934, as amended, or the Exchange Act, and the rules and regulations thereunder, is recorded, processed, summarized and reported within the
time  periods  specified  in  the  SEC’s  rules  and  forms  and  that  such  information  is  accumulated  and  communicated  to  our  management,  including  our  principal
executive  officer  and  principal  financial  officer,  as  appropriate,  to  allow  for  timely  decisions  regarding  required  disclosure.  In  designing  and  evaluating  the
disclosure  controls  and  procedures,  management  recognizes  that  any  controls  and  procedures,  no  matter  how  well  designed  and  operated,  can  provide  only
reasonable assurance of achieving the desired control objectives, and management is required to apply its judgment in evaluating the cost-benefit relationship of
possible controls and procedures.

As  required  by  Rule  13a-15(b)  under  the  Exchange  Act,  our  management,  under  the  supervision  and  with  the  participation  of  our  principal  executive
officer  and  principal  financial  officer,  has  evaluated  the  effectiveness  of  the  design  and  operation  of  our  disclosure  controls  and  procedures  (as  such  term  is
defined  in  Rules  13a-15(e)  and  15d-15(e)  under  the  Exchange  Act)  as  of  December  31,  2020.  Based  on  such  evaluation,  our  principal  executive  officer  and
principal financial officer have concluded that, as of December 31, 2020, our disclosure controls and procedures were effective.

Management’s Annual Report on Internal Control Over Financial Reporting

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  financial  reporting,  as  defined  in  Rule  13a-15(f)  of  the
Exchange Act. Our management conducted an evaluation of the effectiveness of our internal control over financial reporting based on the framework in Internal
Control—Integrated  Framework  (2013)  issued  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission.  Based  on  this  evaluation,
management concluded that our internal control over financial reporting was effective as of December 31, 2020.

This  Annual  Report  on  Form  10-K  does  not  include  an  attestation  report  of  our  registered  public  accounting  firm  on  our  internal  control  over  financial
reporting We are currently a non-accelerated filer and are therefore not required to provide an attestation report on our internal control over financial reporting
until such time as we are an accelerated filer or large accelerated filer.

Changes in Internal Control Over Financial Reporting

There  were  no  changes  in  our  internal  controls  over  financial  reporting  identified  in  management’s  evaluation  pursuant  to  Rules  13a-15(d)  and  15d-
15(d)  of  the  Exchange  Act  that  occurred  during  the  year  ended  December  31,  2020  that  materially  affected,  or  are  reasonably  likely  to  materially  affect,  our
internal control over financial reporting.

Inherent Limitations on Effectiveness of Controls

Our management, including our chief executive officer and chief financial officer, believes that our disclosure controls and procedures and internal control
over financial reporting are designed to provide reasonable assurance of achieving their objectives and are effective at the reasonable assurance level. However,
our management does not expect that our disclosure controls and procedures or our internal control over financial reporting will prevent all errors and all fraud. A
control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are
met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to
their  costs.  Because  of  the  inherent  limitations  in  all  control  systems,  no  evaluation  of  controls  can  provide  absolute  assurance  that  all  control  issues  and
instances  of  fraud,  if  any,  have  been  detected.  These  inherent  limitations  include  the  realities  that  judgments  in  decision-making  can  be  faulty,  and  that
breakdowns can occur because of a simple error or mistake. Additionally, controls can be circumvented by the individual acts of some persons, by collusion of
two or more people or by management override of the controls. The design of any system of controls also is based in part upon certain assumptions about the
likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions; over
time, controls may become inadequate because of changes in conditions, or the degree of compliance with policies or procedures may deteriorate. Because of
the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be detected.

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ITEM 9B.    OTHER INFORMATION

Retention Bonuses

On March 9, 2021, the Compensation Committee (the “Committee”) of the Board of Directors of the Company determined to provide certain incentive
payments (the “Retention Bonuses”) to certain full-time executive officers and vice presidents of the Company, including Jeffrey M. Soinski, Mark Weinswig, and
Himanshu Patel, who serve as the Company’s Chief Executive Officer, Chief Financial Officer, and Chief Technology Officer, respectively (the “Bonus Officers”),
based on certain performance goals. The Retention Bonus consists of incentive payments in an amount equal to 100% of such Bonus Officer’s annual salary as
of December 31, 2023, 50% of which will be paid if such Bonus Officer is in good standing in their service at the Company on December 31, 2023, and 50% to
be paid if such Bonus Officer is in good standing in their service at the Company on December 31, 2024 (each, a “Retention Bonus Payment”). The Retention
Bonus  Payments  may  be  paid  in  cash  or  equity,  or  a  combination  of  both,  as  determined  by  the  Committee.  In  addition,  the  Retention  Bonus  Payments  shall
accelerate in the event of a Change in Control, as defined in the Company’s Amended and Restated 2015 Equity Incentive Plan, provided that the Bonus Officer
remains in his or her respective position through such Change in Control. Each Retention Bonus Payment shall be increased in the event that the price of the
common  stock  of  the  Company  is  above  $3.00  (subject  to  adjustment  for  any  stock  splits,  reverse  stock  splits,  or  similar  transactions)  as  of  the  date  of  such
Retention Bonus Payment, according to the schedule below:

•

•

•

If the stock price is between $3.00 and $3.99 (subject to adjustment for any stock splits, reverse stock splits, or similar transactions) as of the date of the
Retention Bonus Payment, such Retention Bonus Payment shall be increased by 25%;

If the stock price is between $4.00 and $4.99 (subject to adjustment for any stock splits, reverse stock splits, or similar transactions) as of the date of the
Retention Bonus Payment, such Retention Bonus Payment shall be increased by 50%; and

If the stock price is $5.00 or above (subject to adjustment for any stock splits, reverse stock splits, or similar transactions) as of the date of the Retention
Bonus Payment, such Retention Bonus Payment shall be increased by 100%.

The Retention Bonuses are in addition to any other bonus to which the Bonus Officers may be entitled under the Company’s Bonus Plan.

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ITEM 10.    DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE

Directors

PART III

Our business affairs are managed under the direction of our board of directors, which is currently composed of four members.  Three of our directors are
independent within the meaning of the listing standards of The Nasdaq Stock Market, or Nasdaq.  Our board of directors is divided into three staggered classes of
directors.    At  each  annual  meeting  of  stockholders,  a  class  of  directors  will  be  elected  for  a  three-year  term  to  succeed  the  same  class  whose  term  is  then
expiring.

The following table sets forth the names, ages as of March 1, 2021 and certain other information for each of the directors with terms expiring at the 2021
annual meeting of stockholders (the “Annual Meeting”) (who are also nominees for election as a director at the Annual Meeting) and for each of the continuing
members of our board of directors:

Directors
James G. Cullen(1)(2)(3)

Jeffrey M. Soinski

James B. McElwee(1)(2)(3)
Tamara N. Elias(1)(2)(3)

Class  Age  

Position

III

I

II
II

 78

 59

 68
 49

Director and Chairman of the Board
of Directors
President, Chief Executive Officer
and Director

  Director
  Director

Director
Since

 2014

 2014

 2011
 2019

Current
Term
Expires

 2021

 2022

 2023
 2021

(1) Member of our audit committee
(2) Member of our compensation committee
(3) Member of our nominating and corporate governance committee

Jeffrey M. Soinski has served as our President, Chief Executive Officer and a member of our Board of Directors since December 2014. From its formation
in September 2009 until the acquisition of its Unisyn business by GE Healthcare in May 2013, Mr. Soinski served as Chief Executive Officer of Medical Imaging
Holdings  and  its  primary  operating  company  Unisyn  Medical  Technologies,  a  national  provider  of  technology-enabled  products  and  services  to  the  medical
imaging  industry.  Mr.  Soinski  was  a  Director  of  Medical  Imaging  Holdings  and  its  remaining  operating  company  Consensys  Imaging  Service  from  September
2009  until  its  sale  in  October  2017.  Mr.  Soinski  served  periodically  as  a  Special  Venture  Partner  from  July  2008  to  June  2013  and  as  a  Special  Investment
Partner since October 2016 for Galen Partners, a leading healthcare-focused private equity firm, which included Medical Imaging Holdings as one of its portfolio
companies. From 2001 until its acquisition by C.R. Bard in 2008, Mr. Soinski was President and CEO of Specialized Health Products International, a publicly-
traded manufacturer and marketer of proprietary safety medical products. He served on the board of directors of Merriman Holdings, parent of Merriman Capital,
a San Francisco-based investment banking and brokerage firm, from 2008 until March 2016. Mr. Soinski holds a B.A. degree from Dartmouth College.

We  believe  Mr.  Soinski  is  qualified  to  serve  as  a  member  of  our  board  of  directors  because  of  his  extensive  corporate  finance  and  business  strategy

experience as well as his experience with public companies.

James G. Cullen has served as a member of our board of directors since December 2014, as our Lead Independent Director since January 2015 and as
our Non-Executive Chairman since December 2017. During the last five years, Mr. Cullen has held board and committee positions with various companies. Mr.
Cullen is currently a director of Keysight Technologies, which was spun out of Agilent Technologies, where he was previously a director. Mr. Cullen previously
served  as  a  director  and  chairman  of  the  audit  committee  of  Johnson  &  Johnson  and  as  a  director  and  member  of  the  investment  and  finance  committees  of
Prudential Financial. From 1993 to 2000, Mr. Cullen was President, Vice Chairman and Chief Operating Officer of Bell Atlantic Corporation (now Verizon). From
1989 to 1993, he was President and Chief Executive Officer of Bell Atlantic-New Jersey. Mr. Cullen holds a B.A. in Economics from Rutgers University and an
M.S. in Management Science from the Massachusetts Institute of Technology.

We believe Mr. Cullen is qualified to serve as a member of our board of directors because of his extensive experience serving on the boards of public

companies as well as his financial and business expertise.

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James  B.  McElwee has served as a member of our board of directors since March 2011. Mr. McElwee has served as an independent venture capital
investor since 2010. Mr. McElwee served as general partner of Weston Presidio, a private equity and venture capital firm, from 1992 to 2010. During his tenure as
a  general  partner  and  member  of  the  investment  committee,  Weston  Presidio  led  the  start  up  financing  of  JetBlue  Airways  and  made  investments  in  Fender
Musical Instruments, The Coffee Connection, Guitar Center, Mapquest, Party City, Petzazz, RE/MAX, and others.

We  believe  Mr.  McElwee  is  qualified  to  serve  as  a  member  of  our  board  of  directors  because  of  his  substantial  corporate  development  and  business

strategy expertise gained in the venture capital industry.

Tamara  N.  Elias,  M.D.,  was  appointed  to  our  board  of  directors  in  December  2019.  Dr.  Elias  currently  serves  as  VP,  Head  of  Global  Partnerships  at
Merck. Previously she served as Vice President of Clinical Product Development at Aetna from February 2018 to December 2019. From 2015 to 2017, Dr. Elias
was Vice President of Corporate Strategy and Business Development for the $8 billion medical segment at Becton Dickinson. From 2007-2015, Dr. Elias was a
Partner with Essex Woodlands Healthcare Partners, a healthcare only growth equity firm founded in 1985. Earlier in her career, Dr. Elias was a management
consultant  at  McKinsey,  advising  pharmaceutical,  diagnostic  and  device  companies  in  R&D,  product  commercialization  and  M&A.  She  currently  serves  on  the
board  of  REVA  Medical  and  has  also  previously  served  on  the  boards  of  several  private  companies,  including  Millennium  Pharmacy  Systems  (sold  to
PharMerica),  BreatheAmerica  and  Influence  Health  (sold  to  Healthgrades)  as  well  on  the  public  company  board  of  ATS  Medical  (sold  to  Medtronic).  Dr.  Elias
holds degrees in Biology and Anthropology from Yale University, and an M.D. from The Johns Hopkins School of Medicine. She trained as a general surgeon at
Massachusetts General Hospital.

We believe Dr. Elias is qualified to serve as a member of our board of directors because of her substantial corporate development and business strategy

expertise and her experience in the healthcare industry.

Executive Officers

The following table identifies certain information about our executive officers as of March 1, 2021.  Our executive officers are appointed by, and serve at
the discretion of, our board of directors.  Each of our executive officers serves at the discretion of our board of directors and holds office until his successor is duly
elected and qualified or until his earlier resignation or removal.  There are no family relationships among any of our directors or executive officers.

Name
Jeffrey M. Soinski
Mark Weinswig
Himanshu N. Patel

  Age  

Title

 59   President, Chief Executive Officer and Director
 48   Chief Financial Officer
 60   Chief Technology Officer

For a brief biography of Mr. Soinski, please see the section of this Annual Report on Form 10-K titled “ Directors.”

Mark Weinswig has served as our Chief Financial Officer since June 2018. Prior to joining the Company, Mr. Weinswig served as Chief Financial Officer
at Aqua Metals, Inc., a Nasdaq-listed heavy metal recycling company, from August 2017 to March 2018. Mr. Weinswig has previously served as Chief Financial
Officer of One Workplace, a designer and manufacturer of customized workspaces, from July 2016 to July 2017. From October 2010 to June 2016, Mr. Weinswig
served as Chief Financial Officer of Emcore Corporation, a Nasdaq-listed designer and manufacturer of indium phosphide optical chips, components, subsystems
and systems for the broadband and specialty fiber optics market. Earlier in his career Mr. Weinswig worked at Coherent, Inc., Avanex Corporation, which merged
with  Bookham  Technology,  Morgan  Stanley  and  PricewaterhouseCoopers.  He  received  an  M.B.A.  from  the  University  of  Santa  Clara  and  a  B.S.  in  business
administration with an accounting major from Indiana University. He has earned the CFA and CPA designations.

Himanshu  N.  Patel.  co-founded  Avinger  in  2007  and  has  served  as  our  Chief  Technology  Officer  from  January  2011  to  November  2011  and  since
October  2013.  From  September  1999  to  February  2007,  Mr.  Patel  held  various  research  and  development  positions,  including  Director  of  Advanced
Technologies,  at  FoxHollow  Technologies.  Mr.  Patel  previously  held  research  and  development  positions  at  EndoTex  Interventional  Systems  and  General
Surgical Innovations. Mr. Patel holds a B.S. in Mechanical Engineering from M.S. University of Baroda, India, and an M.S. in Mechanical Engineering from the
University of Florida.

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Code of Business Conduct

We have adopted a code of business conduct that applies to all of our employees, officers and directors, including those officers responsible for financial
reporting.  The  code  of  business  conduct  is  available  on  our  website  at www.avinger.com.  Updates  to  or  waivers  of  the  code  will  be  disclosed  on  the  same
website. We intend to satisfy the disclosure requirement under Item 5.05 of Form 8-K regarding any amendment to, or waiver of, any provision of the code in the
future by disclosing such information on our website.

Board Leadership Structure

We believe that the structure of our board of directors and its committees provides strong overall management of our company.  Our board of directors
does not have a formal policy on whether the roles of Chief Executive Officer and Chairman of our board of directors should be separate.  However, Messrs.
Soinski and Cullen, respectively, hold these positions at present.

Our Chief Executive Officer, Mr. Soinski, is responsible for setting the strategic direction of our company, the general management and operation of the
business and the guidance and oversight of senior management.  In his capacity as Chairman of our board of directors, Mr. Cullen is also responsible for the
guidance and oversight of senior management, monitoring the content, quality and timeliness of information sent to our board of directors, consultation with our
board of directors regarding the oversight of our business affairs, presiding over meetings of our board of directors and performing such additional duties as our
Board may otherwise determine and delegate.  At the end of each board meeting, the independent directors are expected to meet in executive session, without
Mr.  Soinski  present.    Following  each  meeting,  Mr.  Cullen  is  expected  to  provide  feedback  to  Mr.  Soinski  on  his  performance  and  the  performance  of  our
employees during the meeting and to recommend new agenda items for the next meeting.

Director Independence

Our common stock is listed on The Nasdaq Capital Market.  Under the Nasdaq listing standards, independent directors must comprise a majority of a
listed company’s board of directors.  In addition, the Nasdaq listing standards require that, subject to specified exceptions, each member of a listed company’s
audit, compensation, and nominating and corporate governance committees be independent.  Under the Nasdaq listing standards, a director will only qualify as
an  “independent  director”  if,  in  the  opinion  of  that  listed  company’s  board  of  directors,  that  director  does  not  have  a  relationship  that  would  interfere  with  the
exercise of independent judgment in carrying out the responsibilities of a director.

Audit committee members must also satisfy the additional independence criteria set forth in Rule 10A-3 under the Securities Exchange Act of 1934, as
amended, or the “Exchange Act, and the Nasdaq listing standards.  Compensation committee members must also satisfy the additional independence criteria set
forth in Rule 10C-1 under the Exchange Act and the Nasdaq listing standards. 

Our board of directors has undertaken a review of the independence of each of our directors.  Based on information provided by each director concerning
his background, employment and affiliations, our board of directors has determined that Messrs. Cullen, McElwee and Dr. Elias do not have a relationship that
would interfere with the exercise of independent judgment in carrying out the responsibilities of a director and that each of these directors is “independent” as that
term is defined under the Nasdaq listing standards.  In making these determinations, our board of directors considered the current and prior relationships that
each  non-employee  director  has  with  our  company  and  all  other  facts  and  circumstances  our  board  of  directors  deemed  relevant  in  determining  their
independence, including the beneficial ownership of our capital stock by each non-employee director, and the transactions involving them described below under
the heading “Related Person Transactions.”

Board Meetings and Committees

During our fiscal year ended December 31, 2020, our board of directors held 18 meetings (including regularly scheduled and special meetings), and each
director  attended  at  least  75%  of  the  aggregate  of  (i)  the  total  number  of  meetings  of  our  board  of  directors  held  during  the  period  for  which  he  has  been  a
director and (ii) the total number of meetings held by all committees of our board of directors on which he served during the periods that he served.  All of our
directors who were directors at the time attended our 2020 annual meeting of stockholders telephonically.

Although  we  do  not  have  a  formal  policy  regarding  attendance  by  members  of  our  board  of  directors  at  annual  meetings  of  stockholders,  we  strongly

encourage our directors to attend.

Our  board  of  directors  has  established  an  audit  committee,  a  compensation  committee  and  a  nominating  and  corporate  governance  committee.    The
composition and responsibilities of each of the committees of our board of directors are described below.  Members will serve on these committees until their
resignation or until as otherwise determined by our board of directors.

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Audit Committee

Messrs. McElwee, Cullen and Dr. Elias serve on our audit committee.  Mr. Cullen serves as the chair of the audit committee.  Our board of directors has
assessed whether all members of the audit committee meet the composition requirements of Nasdaq, including the requirements regarding financial literacy and
financial  sophistication.    Our  board  of  directors  found  that  Messrs.  McElwee,  Cullen  and  Dr.  Elias  have  met  the  financial  literacy  and  financial  sophistication
requirements and that Messrs. McElwee, Cullen and Dr. Elias are independent under SEC and Nasdaq rules.  In addition, our board of directors has determined
that Mr. Cullen is an audit committee financial expert within the meaning of Item 407(d) of Regulation S-K under the Securities Act of 1933, as amended, or the
Securities Act.  The audit committee’s primary responsibilities include:

•

•

•

appointing, approving the compensation of, and assessing the qualifications and independence of our independent registered public accounting firm,
which currently is Moss Adams LLP;

reviewing and discussing with management and our independent registered public accounting firm our annual and quarterly financial statements and
related disclosures;

preparing the audit committee report required by SEC rules to be included in our annual proxy statements;

• monitoring our internal control over financial reporting, disclosure controls and procedures;

•

•

reviewing our risk management status;

establishing policies regarding hiring employees from our independent registered public accounting firm and procedures for the receipt and retention
of accounting related complaints and concerns;

• meeting independently with our independent registered public accounting firm and management; and

• monitoring compliance with the code of business conduct and ethics for financial management.

All audit and non-audit services must be approved in advance by the audit committee.  Our audit committee operates under a written charter that satisfies
the  applicable  rules  and  regulations  of  the  SEC  and  Nasdaq  listing  standards.    A  copy  of  the  charter  of  our  audit  committee  is  available  on  our  website  at
www.avinger.com under “Investors–Governance.” During our fiscal year ended December 31, 2020, our audit committee held four meetings.

Compensation Committee

Messrs. Cullen, McElwee and Dr. Elias serve on our compensation committee.  Mr. McElwee serves as the chair of the compensation committee.  Each
member of our compensation committee meets the requirements for independence for compensation committee members under the Nasdaq listing standards
and SEC rules and regulations, including Rule 10C-1 under the Exchange Act.  Each member of our compensation committee is also a non-employee director,
as  defined  pursuant  to  Rule  16b-3  promulgated  under  the  Exchange  Act,  and  an  outside  director,  as  defined  pursuant  to  Section  162(m)  of  the  Internal
Revenue Code.  Our compensation committee is responsible for, among other things:

•

•

•

•

annually  reviewing  and  approving  corporate  goals  and  objectives  relevant  to  compensation  of  our  chief  executive  officer  and  our  other  executive
officers;

determining the compensation of our chief executive officer and our other executive officers;

reviewing and making recommendations to our board of directors with respect to director compensation; and

overseeing and administering our equity incentive plans.

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Our Chief Executive Officer and Chief Financial Officer make compensation recommendations for our other executive officers and initially propose the
corporate and departmental performance objectives under our Executive Incentive Compensation Plan to the compensation committee.  From time to time, the
compensation committee may use outside compensation consultants to assist it in analyzing our compensation programs and in determining appropriate levels of
compensation and benefits.  For example, we have periodically engaged Radford, a business unit of Aon Hewitt, to help develop our compensation philosophy,
select  a  group  of  peer  companies  to  use  for  compensation  benchmarking  purposes  and  advise  on  cash  and  equity  compensation  levels  for  our  directors,
executives and other employees based on current market practices.  We did not use any compensation consultants during our year ended December 31, 2020.
Our compensation committee operates under a written charter that satisfies the applicable rules and regulations of the SEC and Nasdaq listing standards.  A copy
of  the  charter  of  our  compensation  committee  is  available  on  our  website  at www.avinger.com  under  “Investors–Governance.”  During  our  fiscal  year  ended
December 31, 2020, our compensation committee held four meetings.

Nominating and Corporate Governance Committee

Messrs.  Cullen,  McElwee  and  Dr.  Elias  serve  on  our  nominating  and  governance  committee.    Dr.  Elias  serves  as  the  chair  of  the  nominating  and
governance  committee.    Each  member  of  our  nominating  and  corporate  governance  committee  meets  the  requirements  for  independence  under  the  Nasdaq
listing standards and SEC rules and regulations.  Our nominating and corporate governance committee is responsible for, among other things:

•

•

•

•

•

identifying individuals qualified to become members of our board of directors;

recommending to our board of directors the persons to be nominated for election as directors and to each of our board’s committees;

reviewing and making recommendations to our board of directors with respect to management succession planning;

developing, updating and recommending to our board of directors corporate governance principles and policies; and

overseeing the evaluation of our board of directors and committees.

Our nominating and corporate governance committee operates under a written charter that satisfies the applicable Nasdaq listing standards.  A copy of
the charter of our nominating and corporate governance committee is available on our website at www.avinger.com under “Investors–Governance.”  During  our
fiscal year ended December 31, 2020, our nominating and corporate governance committee held one meeting.

Considerations in Evaluating Director Nominees

Our  nominating  and  corporate  governance  committee  uses  a  variety  of  methods  for  identifying  and  evaluating  director  nominees.    In  its  evaluation  of
director candidates, our nominating and corporate governance committee will consider the current size and composition of our board of directors and the needs
of  our  board  of  directors  and  the  respective  committees  of  our  board  of  directors.    Some  of  the  qualifications  that  our  nominating  and  corporate  governance
committee  considers  include,  without  limitation,  issues  of  character,  integrity,  judgment,  diversity  of  experience,  independence,  area  of  expertise,  corporate
experience, length of service, potential conflicts of interest and other commitments. We also look for nominees who have skills and experience that would support
the short and long-term goals and strategy of the Company. Our nominating and corporate governance committee seeks to maintain an appropriate balance of
backgrounds, skills, knowledge, and experience to support current and future needs. Nominees must also have the ability to offer advice and guidance to our
Chief Executive Officer based on past experience in positions with a high degree of responsibility and be leaders in the companies or institutions with which they
are affiliated.

In the case of incumbent directors whose terms of office are set to expire, our nominating and corporate governance committee reviews these directors’
overall  service  to  the  Company  during  their  terms,  including  the  number  of  meetings  attended,  level  of  participation,  quality  of  performance  and  any  other
relationships and transactions that might impair the directors’ independence.

Director  candidates,  including  incumbent  directors,  must  have  sufficient  time  available  in  the  judgment  of  our  nominating  and  corporate  governance
committee to perform all board of director and committee responsibilities.  Members of our board of directors are expected to prepare for, attend and participate in
all  board  of  director  and  applicable  committee  meetings.    Other  than  the  foregoing,  there  are  no  stated  minimum  criteria  for  director  nominees,  although  our
nominating and corporate governance committee may also consider such other factors as it may deem, from time to time, are in our and our stockholders’ best
interests.

Although  our  board  of  directors  does  not  maintain  a  specific  policy  with  respect  to  board  diversity,  our  board  of  directors  believes  that  our  board  of
directors  should  be  a  diverse  body,  and  our  nominating  and  corporate  governance  committee  considers  a  broad  range  of  backgrounds  and  experiences.    In
making  determinations  regarding  nominations  of  directors,  our  nominating  and  corporate  governance  committee  may  take  into  account  the  benefits  of  diverse
viewpoints,  backgrounds,  and  experiences.    Our  nominating  and  corporate  governance  committee  also  considers  these  and  other  factors  as  it  oversees  the
annual board of director and committee evaluations.  After completing its review and evaluation of director candidates, our nominating and corporate governance
committee recommends to our full board of directors the director nominees for selection.

In addition to utilizing personal networks and relationships to identify potential candidates, our nominating and corporate governance committee may also
engage,  if  it  deems  appropriate,  a  professional  search  firm.  The  nominating  and  corporate  governance  committee  conducts  any  appropriate  and  necessary
inquiries  into  the  backgrounds  and  qualifications  of  possible  candidates  after  considering  the  function  and  needs  of  the  board.  The  nominating  and  corporate
governance committee meets to discuss and consider the candidates’ qualifications and then selects a nominee for recommendation to the board.

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Stockholder Recommendations for Nominations to the Board of Directors

Our  nominating  and  corporate  governance  committee  will  consider  candidates  for  director  recommended  by  stockholders,  so  long  as  such
recommendations comply with our amended and restated certificate of incorporation, amended and restated bylaws and applicable laws, rules and regulations,
including  those  promulgated  by  the  SEC.    Our  nominating  and  corporate  governance  committee  will  evaluate  such  recommendations  in  accordance  with  its
charter, our amended and restated bylaws, our policies and procedures for director candidates, as well as the regular director nominee criteria described above. 
This process is designed to ensure that our board of directors includes members with diverse backgrounds, skills and experience, including appropriate financial
and other expertise relevant to our business.  Eligible stockholders wishing to recommend a candidate for nomination should contact our Secretary in writing. 
Such recommendations must include information about the candidate, a statement of support by the recommending stockholder, evidence of the recommending
stockholder’s ownership of our common stock and a signed letter from the candidate confirming willingness to serve on our board of directors.  Our nominating
and corporate governance committee has discretion to decide which individuals to recommend for nomination as directors.

Under our amended and restated bylaws, stockholders may also nominate candidates for our board of directors.  Any nomination must comply with the
requirements set forth in our amended and restated bylaws and should be sent in writing to our Secretary at 400 Chesapeake Drive, Redwood City, California
94063.  To be timely for our 2021 annual meeting of stockholders, our Secretary must receive the nomination no earlier than August 12, 2021 and no later than
September 11, 2021.

ITEM 11.    EXECUTIVE COMPENSATION

Processes and Procedures for Compensation Decisions

Our compensation committee is responsible for the executive compensation programs for our executive officers and reports to our board of directors on
its discussions, decisions and other actions.  Our compensation committee reviews and approves corporate goals and objectives relating to the compensation of
our  Chief  Executive  Officer,  evaluates  the  performance  of  our  Chief  Executive  Officer  in  light  of  those  goals  and  objectives  and  determines  and  approves  the
compensation of our Chief Executive Officer based on such evaluation.  Our compensation committee has the sole authority to determine our Chief Executive
Officer’s compensation.  In addition, our compensation committee, in consultation with our Chief Executive Officer, reviews and approves all compensation for
other  officers.  Our  Chief  Executive  Officer  and  Chief  Financial  Officer  also  make  compensation  recommendations  for  our  other  executive  officers  and  initially
propose the corporate and departmental performance objectives under our Executive Incentive Compensation Plan to the compensation committee.

The  compensation  committee  is  authorized  to  retain  the  services  of  one  or  more  executive  compensation  and  benefits  consultants  or  other  outside

experts or advisors as it sees fit, in connection with the establishment of our compensation programs and related policies. 

Summary Compensation Table

The following table presents summary information regarding the total compensation for services rendered in all capacities that was earned by our Chief
Executive Officer and our two other most highly compensated executive officers in our fiscal years ended December 31, 2020 and 2019.  The individuals listed in
the table below are our named executive officers for our fiscal year ended December 31, 2020.

Salary
($)(2)

    Bonus ($)    

Stock
Awards
($)(1)

Option
Awards
($)(1)

Non-Equity
Incentive Plan
Compensation
($)(4)

All Other
Compensation
($)

Name and Principal Position   Year
Jeffrey M. Soinski(3)
President and Chief Executive
Officer
Himanshu Patel (3)
Chief Technology Officer
Mark B. Weinswig
Chief Financial Officer

2020     376,667     

2019     399,168     
2020     282,500     
2019     298,333     
2020     282,500     
2019     300,000     

-     

-     
-     
-     
-     
-     

-     

86,250     
-     
57,500     
-     
57,500     

-     

-     
-     
-     
-     
-     

128,236     

121,988     
76,942     
71,101     
76,942     
74,448     

    Total ($)  
-      495,903 

-      607,406 
-      359,442 
-      426,935 
-      359,442 
-      431,948 

(1) The amounts reported represent the aggregate grant-date fair value of the stock awards and stock options awarded to the named executive officer in 2020
and 2019, calculated in accordance with ASC Topic 718.  Such grant-date fair value does not take into account any estimated forfeitures related to service-
vesting conditions.  The assumptions used in calculating the grant-date fair value of the options reported in this column are set forth in the section of this
Annual Report on Form 10-K titled “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Critical Accounting Policies
and Estimates—Stock-Based Compensation.”

(2) The amounts reported for 2020 are inclusive of salary reductions for the above individuals as part of temporary cost saving measures employed by the

company due to the adverse effects of COVID-19 pandemic on its business.

(3) Mr. Soinski's and Mr. Patel's salary were increased in February 2019 to $400,000 and $300,000, respectively.
(4) Non-equity incentive plan compensation includes cash awards granted at the discretion of the Compensation Committee under our Executive Incentive

Compensation Plan for achieving certain performance-based criteria.

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Executive Employment Letters

Jeffrey M. Soinski

We  entered  into  an  employment  offer  letter  in  December  2014  with  Jeffrey  M.  Soinski,  our  President  and  Chief  Executive  Officer.    The  letter  has  no
specific term and provides for at-will employment.  The letter also provides that, in 2015, Mr. Soinski was eligible to receive an annual performance bonus of up
to 40% of his annual salary based on the achievement of certain goals mutually agreed upon by him and our board of directors.  Effective January 1, 2016, Mr.
Soinski’s annual base salary was $390,000 and his target bonus percentage was increased from 40% to 50%. Effective February 1, 2019, Mr. Soinski’s annual
base salary was increased to $400,000. On September 9, 2020, Mr. Soinski’s target bonus percentage was increased from 50% to 75%.

Pursuant to Mr. Soinski’s employment offer letter, if, within the 12-month period following a “change in control,” we terminate Mr. Soinski’s employment
without “cause,” or Mr. Soinski resigns for “good reason” (as such terms are defined in Mr. Soinski’s employment offer letter), Mr. Soinski will receive accelerated
vesting as to 100% of his outstanding unvested stock options.  If we experience a change in control, and Mr. Soinski remains our employee through such date,
Mr. Soinski will receive accelerated vesting as to 50% of his outstanding unvested stock options and/or restricted stock.

If we terminate Mr. Soinski without cause at any time, he will be entitled to receive 12 months of base salary and COBRA medical and dental insurance
coverage,  in  each  case  payable  in  substantially  equal  installments  in  accordance  with  our  payroll  practices,  as  severance,  in  exchange  for  signing  and  not
revoking a severance agreement and general release against us and our affiliates within 60 days following his termination of employment. 

Mark Weinswig

Pursuant  to  an  Employment  Offer  Letter  between  the  Company  and  Mr.  Weinswig,  dated  as  of  June  11,  2018,  Mr.  Weinswig  is  entitled  to  receive  as
compensation (i) a base salary of $300,000; (ii) a discretionary bonus targeted at 40% of his base salary, subject to achievement of mutually agreed performance
goals and payable semi-annually; and (iii) other standard benefits provided to each of the Company’s executive officers. On September 9, 2020, Mr. Weinswig’s
target bonus percentage was increased from 40% to 60%.

401(k) Plan

We maintain a tax-qualified retirement plan that provides eligible employees with an opportunity to save for retirement on a tax advantaged basis.  We
may make a discretionary matching contribution to the 401(k) plan, and may make a discretionary employer contribution to each eligible employee each year.  To
date,  we  have  not  made  any  matching  or  profits  sharing  contributions  into  the  401(k)  plan.    All  participants’  interests  in  our  matching  and  profit  sharing
contributions, if any, vest pursuant to a four-year graded vesting schedule from the time of contribution.  Pre-tax contributions are allocated to each participant’s
individual account and are then invested in selected investment alternatives according to the participants’ directions.  The 401(k) plan is intended to qualify under
Sections 401(a) and 501(a) of the Code.  As a tax-qualified retirement plan, contributions to the 401(k) plan and earnings on those contributions are not taxable to
the employees until distributed from the 401(k) plan, and all contributions are deductible by us when made. 

Pension Benefits and Nonqualified Deferred Compensation

We do not provide a pension plan for our employees, and none of our named executive officers participated in a nonqualified deferred compensation plan

in 2020.

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Outstanding Equity Awards at Fiscal Year-End

The following table provides information regarding equity awards held by our named executive officers at December 31, 2020.

  Option Awards

Number of
Securities
Underlying
Unexercised
Options (#)

Number of
Securities
Underlying
Unexercised
Options (#)

Option
Exercise
Price
($)(4)

Option
Expiration
Date

    Stock Awards
Number of
Shares or
Units of
Stock
That
Have Not
Vested (#)

Market
Value of
Shares or
Units of
Stock That
Have Not
Vested
($)(5)

Exercisable
(3)

    Unexercisable

Name
Jeffrey M. Soinski

Himanshu Patel

Mark Weinswig

Grant Date
  12/31/2014(1)(7)   
3/7/2016 (2)(7)   
  3/13/2017 (2) (7)   
3/13/2017 (2)(8)   
9/5/2018(2) (9)   
9/18/2019(2) (9)   

  11/5/2013 (1) (6)   
  12/31/2014(1)(7)   
3/3/2016(2) (7)   
  3/13/2017 (2) (7)   
  3/13/2017 (2) (8)   
9/5/2018(2) (9)   
9/18/2019(2) (9)   

9/5/2018(2) (9)   
9/18/2019(2) (9)   

1,549     
151     
142     
—     
—     
—     

57     
435     
63     
71     
—     
—     
—     

—     
—     

—     
—     
9     
—     
—     
—     

—     
—     
—     
5     
—     
—     
—     

—     
—     

1,800   
5,184   
820   

—     
—     
—     

8,100   
1,800   
5,196   
820   

—     
—     
—     

—     
—     

12/31/2024     
3/7/2026     
3/13/2027     
—     
—     
—     

11/5/2023     
12/31/2024     
3/3/2026     
3/13/2027     
—     
—     
—     

—     
—     

—     
—     
—     
18     
16,666     
50,000     

—     
—     
—     
—     
9     
10,000     
33,334     

8,333     
33,334     

— 
— 
— 
8 
7,335 
22,005 

— 
— 
— 
— 
4 
4,401 
14,670 

3,667 
14,670 

(1) Each of the outstanding equity awards was granted pursuant to our 2009 Stock Plan.  No additional awards may be granted under the 2009 Stock Plan, and
all awards granted under the 2009 Stock Plan that are repurchased, forfeited, expire, are cancelled or otherwise not issued become available for grant under
the 2015 Plan in accordance with its terms.

(2) Each of the outstanding equity awards was granted pursuant to our 2015 Equity Incentive Plan.
(3) All of our options granted pursuant to our 2009 Stock Plan are early exercisable subject to the Company’s right to repurchase any unvested shares.
(4) This column represents the fair value of a share of our common stock on the date of grant, as determined by our board of directors.
(5) This column represents the market value of the unvested shares of our common stock underlying the RSUs as of December 31, 2020, based on the closing

price of our common stock, as reported on the Nasdaq Global Select Market, of $0.44 per share.

(6) 25%  of  the  shares  of  our  common  stock  subject  to  this  option  vested  on  October  11,  2014,  and  the  balance  vested  in  36  successive  equal  monthly

installments, subject to continued service through each such vesting date.

(7) 25% of the shares of our common stock subject to this option vested on the one year anniversary of the grant date, and the balance vests in 36 successive

equal monthly installments, subject to continued service through each such vesting date.

(8) 25%  of  the  shares  of  our  common  stock  subject  to  this  stock  award  vests  on  the  one  year  anniversary  of  the  grant  date,  and  the  balance  vests  in  3

successive equal annual installments, subject to continued service through each such vesting date.

(9) 33.3%  of  the  shares  of  our  common  stock  subject  to  this  stock  award  vests  on  the  one  year  anniversary  of  the  grant  date,  and  the  balance  vests  in  2

successive equal annual installments, subject to continued service through each such vesting date.

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Potential Payments upon Termination or Change of Control

Jeffrey M. Soinski

In March 2018, we entered into a change of control and severance agreement with Jeffrey M. Soinski, which was subsequently amended in March 2020.
Under this agreement, as amended, if, within the 18 month period following a “change of control,” we terminate Mr. Soinski’s employment other than for “cause,”
death or disability, or the employee resigns for “good reason” (as such terms are defined in the employee’s employment agreement) and, within 60 days following
the employee’s termination, the employee executes an irrevocable separation agreement and release of claims, the employee is entitled to receive (i) continuing
payments of severance pay at a rate equal to the employee’s monthly base salary and pro-rated target bonus, as then in effect, for a period of 12 months plus
one month for every year of service completed for the Company (provided that such severance shall not exceed 18 months), (ii) reimbursement of premiums to
maintain  group  health  insurance  continuation  benefits  pursuant  to  “COBRA”  for  employee  and  employee’s  dependents  for  up  to  12  months,  (iii)  accelerated
vesting as to 100% of the employee’s outstanding unvested stock options and/or restricted stock, and (iv) the extension of the post-termination exercise period of
any options held by the employee for a period of 1 year.  Additionally, if we experience a change in control, 50% of Mr. Soinski’s outstanding unvested stock
options  and/or  restricted  stock  will  vest.  In  the  event  of  any  conflict  between  Mr.  Soinski’s  change  of  control  and  severance  agreement  and  his  offer  letter,
described above under “Executive Employment Letters,” he will be entitled to the greater of the benefits provided by either. The agreement also provides that if
the employee is employed by the Company or the Company’s successor on the date that is 12 months following a change of control, then the employee will be
entitled  to  a  lump  sum  bonus  payment  in  an  amount  equal  to  what  the  employee  would  have  received  as  a  severance  payment  if  the  employee  had  been
terminated other than for cause, death or disability.

Himanshu Patel

We previously entered into a change of control and severance agreement with Himanshu Patel, which was subsequently amended in March 2020. Under
this agreement, as amended, if, within the 18 month period following a “change of control,” we terminate Mr. Patel’s employment other than for “cause,” death or
disability,  or  the  employee  resigns  for  “good  reason”  (as  such  terms  are  defined  in  the  employee’s  employment  agreement)  and,  within  60  days  following  the
employee’s  termination,  the  employee  executes  an  irrevocable  separation  agreement  and  release  of  claims,  the  employee  is  entitled  to  receive  (i)  continuing
payments of severance pay at a rate equal to the employee’s monthly base salary and pro-rated target bonus, as then in effect, for a period of 12 months plus
one month for every year of service completed for the Company (provided that such severance shall not exceed 18 months), (ii) reimbursement of premiums to
maintain  group  health  insurance  continuation  benefits  pursuant  to  “COBRA”  for  employee  and  employee’s  dependents  for  up  to  12  months,  (iii)  accelerated
vesting as to 100% of the employee’s outstanding unvested stock options and/or restricted stock, and (iv) the extension of the post-termination exercise period of
any  options  held  by  the  employee  for  a  period  of  1  year.  The  agreement  also  provides  that  if  the  employee  is  employed  by  the  Company  or  the  Company’s
successor on the date that is 12 months following a change of control, then the employee will be entitled to a lump sum bonus payment in an amount equal to
what the employee would have received as a severance payment if the employee had been terminated other than for cause, death or disability.

Mark Weinswig

In  June  2018,  we  entered  into  a  change  of  control  and  severance  agreement  with  Mark  Weinswig,  which  was  subsequently  amended  in  March  2020.
Under  this  agreement,  as  amended,  if,  within  the  18  month  period  following  a  “change  of  control,”  we  terminate  Mr.  Weinswig’s  employment  other  than  for
“cause,” death or disability, or the employee resigns for “good reason” (as such terms are defined in the employee’s employment agreement) and, within 60 days
following the employee’s termination, the employee executes an irrevocable separation agreement and release of claims, the employee is entitled to receive (i)
continuing payments of severance pay at a rate equal to the employee’s monthly base salary and pro rated target bonus, as then in effect, for 12 months plus one
month  for  every  year  of  service  completed  for  the  Company  (provided  that  such  severance  shall  not  exceed  18  months),  (ii)  reimbursement  of  premiums  to
maintain  group  health  insurance  continuation  benefits  pursuant  to  “COBRA”  for  employee  and  employee’s  dependents  for  up  to  12  months,  (iii)  accelerated
vesting as to 100% of the employee’s outstanding unvested stock options and/or restricted stock, and (iv) the extension of the post-termination exercise period of
any options held by the employee for a period of 1 year.  Additionally, if we experience a change in control, 50% of Mr. Weinswig’s outstanding unvested stock
options  and/or  restricted  stock  will  vest.  In  the  event  of  any  conflict  between  Mr.  Weinswig’s  change  of  control  and  severance  agreement  and  his  offer  letter,
described above under “Executive Employment Letters,” he will be entitled to the greater of the benefits provided by either. The agreement also provides that if
the employee is employed by the Company or the Company’s successor on the date that is 12 months following a change of control, then the employee will be
entitled  to  a  lump  sum  bonus  payment  in  an  amount  equal  to  what  the  employee  would  have  received  as  a  severance  payment  if  the  employee  had  been
terminated other than for cause, death or disability.

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Executive Incentive Compensation Plan

Our board of directors has adopted an Executive Incentive Compensation Plan, or the Bonus Plan, that is administered by our compensation committee. 
The  Bonus  Plan  allows  our  compensation  committee  to  provide  cash  incentive  awards  to  selected  employees,  including  our  named  executive  officers,  based
upon performance goals established by our compensation committee.

Under  the  Bonus  Plan,  our  compensation  committee  determines  the  performance  goals  applicable  to  any  award,  which  goals  may  include,  without
limitation: attainment of research and development milestones, sales bookings, business divestitures and acquisitions, cash flow, cash position, earnings (which
may include any calculation of earnings, including but not limited to earnings before interest and taxes, earnings before taxes, earnings before interest, taxes,
depreciation and amortization and net earnings), earnings per share, net income, net profit, net sales, operating cash flow, operating expenses, operating income,
operating  margin,  overhead  or  other  expense  reduction,  product  defect  measures,  product  release  timelines,  productivity,  profit,  return  on  assets,  return  on
capital, return on equity, return on investment, return on sales, revenue, revenue growth, sales results, sales growth, stock price, time to market, total stockholder
return, working capital, and individual objectives such as peer reviews or other subjective or objective criteria.  Performance goals that include our financial results
may be determined in accordance with GAAP or such financial results may consist of non-GAAP financial measures and any actual results may be adjusted by
the  compensation  committee  for  one-time  items  or  unbudgeted  or  unexpected  items  when  performance  goals  that  include  our  financial  results  may  be
determined  in  accordance  with  GAAP,  or  such  financial  results  may  consist  of  non-GAAP  financial  measures,  and  any  actual  results  may  be  adjusted  by  the
compensation committee for one-time items or unbudgeted or unexpected items when determining whether the performance goals have been met.  The goals
may  be  on  the  basis  of  any  factors  the  compensation  committee  determines  relevant,  and  may  be  adjusted  on  an  individual,  divisional,  business  unit  or
company-wide basis.  The performance goals may differ from participant to participant and from award to award.

Our  compensation  committee  may,  in  its  sole  discretion  and  at  any  time,  increase,  reduce  or  eliminate  a  participant’s  actual  award,  and/or  increase,
reduce  or  eliminate  the  amount  allocated  to  the  bonus  pool  for  a  particular  performance  period.    The  actual  award  may  be  below,  at  or  above  a  participant’s
target award, in the compensation committee’s discretion.  Our compensation committee may determine the amount of any reduction on the basis of such factors
as it deems relevant, and it is not required to establish any allocation or weighting with respect to the factors it considers.

Actual  awards  are  paid  in  cash  only  after  they  are  earned,  which  usually  requires  continued  employment  through  the  date  a  bonus  is  paid.    Our
compensation committee has the authority to amend, alter, suspend or terminate the Bonus Plan provided such action does not impair the existing rights of any
participant with respect to any earned bonus.

Director Compensation

Our board of directors approved our Outside Director Compensation Policy in January 2015 to compensate each non-employee director for his or her
service, and amended certain aspects of this policy in August 2018.  Our board of directors will have the discretion to revise non-employee director compensation
as it deems necessary or appropriate.  Under our Outside Director Compensation Policy, non-employee directors will receive compensation in the form of equity
and cash, as described below:

Cash Compensation.  All non-employee directors will be entitled to receive the following cash compensation for their services:

•

•

•

•

•

•

•

•

$35,000 per year for service as a board member;

$25,000 per year additionally for service as chairman of the board;

$20,000 per year additionally for service as chairman of the audit committee;

$10,000 per year additionally for service as an audit committee member;

$15,000 per year additionally for service as chairman of the compensation committee;

$7,500 per year additionally for service as a compensation committee member;

$10,000 per year additionally for service as chairman of the nominating and corporate governance committee; and

$5,000 per year additionally for service as a nominating and corporate governance committee member.

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All cash payments to non-employee directors, or the Retainer Cash Payments, will be paid semiannually with the first semiannual installment payable on
the  date  of  our  annual  meeting  of  stockholders  or,  if  no  annual  meeting  occurs  in  a  given  year,  May  1,  and  the  second  semiannual  installment  payable  on
November 1 of each year.

Election to Receive RSUs in Lieu of Cash Payments.   All non-employee directors may elect to convert a Retainer Cash Payment into RSUs, or Retainer
RSUs, with a grant date fair value equal to the applicable Retainer Cash Payment.  Each Retainer RSU will be granted on the date that the applicable Retainer
Cash Payment was scheduled to be paid, and all of the shares underlying the Retainer RSUs will vest and become exercisable six months from the date of grant,
subject to continued service as a director through the applicable vesting date.  The Retainer RSUs will be subject to certain terms and conditions as described
below under the section titled “Director Compensation—Equity Compensation.”

Elections to convert a Retainer Cash Payment into a Retainer RSU must generally be made on or prior to December 31 of the year prior to the year in
which the Retainer Cash Payment is scheduled to be paid, or such earlier deadline as is established by our board of directors or compensation committee.  A
newly  appointed  non-employee  director  will  be  permitted  to  elect  to  convert  Retainer  Cash  Payments  payable  in  the  same  calendar  year  into  Retainer  RSUs,
provided that such election is made prior to the date the individual becomes a non-employee director.

Equity Compensation.  Nondiscretionary, automatic grants of RSUs will be made to our non-employee directors.

•

•

Initial Grant.  Generally, each person who first becomes a non-employee director will be granted RSUs having a grant date fair value equal to
$115,000, or the Initial Grant.  The Initial Grant will typically be granted on the date of the first meeting of our board of directors or compensation
committee occurring on or after the date on which the individual first became a non-employee director.  The Initial Grant will vest and become
exercisable as to one thirty-sixth (1/36th) of the shares subject to such Initial Grant on each monthly anniversary of the commencement of the non-
employee director’s service as a director, subject to the continued service as a director through the applicable vesting date.

Annual Grant.  Once each calendar year, on the same date that our board of directors grants annual equity awards to our senior executives, each
non-employee director will be granted RSUs having a grant date fair value equal to $75,000, or the Annual Grant.  All of the shares underlying the
Annual Grant will vest and become exercisable one year from the date of grant, subject to continued service as a director through the applicable
vesting date.

The grant date fair value is the closing sales price for the Company’s common stock (or the closing bid, if no sales were reported) as quoted on such

exchange or system on the date such award is granted.

Any RSUs granted under our outside director compensation policy will fully vest and become exercisable in the event of a change in control, as defined in
our  2015  Plan,  provided  that  the  holder  remains  a  director  through  such  change  in  control.    Further,  our  2015  Plan  provides  that  in  the  event  of  a  merger  or
change in control, as defined in our 2015 Plan, each outstanding equity award granted under our 2015 Plan that is held by a non-employee director will fully vest,
all restrictions on the shares subject to such award will lapse and, with respect to awards with performance-based vesting, all performance goals or other vesting
criteria will be deemed achieved at 100% of target levels, and all of the shares subject to such award will become fully exercisable, if applicable, provided such
optionee remains a director through such merger or change in control.

2021 Changes to Director Compensation

Notwithstanding the above, pursuant to the authority of our board of directors to revise non-employee director compensation, our board of directors has
deemed it appropriate and necessary to pay the Annual Grant for the year 2021 in the amount of $75,000 in cash, in lieu of making the 2021 Annual Grant in the
form of RSUs.

Compensation for Fiscal Year 2020

The following table sets forth a summary of the compensation received by our non-employee directors who received compensation during our fiscal year

ended December 31, 2020:

Name

James G. Cullen
James B. McElwee
Tamara Elias

Fees earned
or

    Option awards(1)

  paid in cash
  $

92,500    $
65,000     
84,773     

    Stock
    awards(2)
-    $
-     
-     

    Total

-    $
-     
-     

92,500 
65,000 
84,773 

(1) As of December 31, 2020, Messrs. Cullen and McElwee had outstanding options to purchase a total of 3,429 and 286 shares of our common stock,

respectively.

(2) During 2020, all non-employee directors that were directors at the time of grant did not receive an Annual RSU grant due to insufficient shares available

within the 2015 Stock Plan.

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Directors who are also our employees receive no additional compensation for their service as directors.  During 2020, Jeffrey M. Soinski, our President,
Chief Executive Officer and a director, was also our employee.  See the section titled “Summary Compensation Table” below for additional information about the
compensation for Mr. Soinski.

Officer and Director Share Purchase Plan

On  August  22,  2018,  the  Board  of  Directors  of  the  Company  approved  the  adoption  of  an  Officer  and  Director  Share  Purchase  Plan  (“ODPP”),  which
allows executive officers and directors to purchase shares of our common stock at fair market value in lieu of salary or, in the case of directors, director fees.
Eligible  individuals  may  voluntarily  participate  in  the  ODPP  by  authorizing  payroll  deductions  or,  in  the  case  of  directors,  deductions  from  director  fees  for  the
purpose of purchasing common stock. Elections to participate in the ODPP may only be made during open trading windows under our insider trading policy when
the  participant  does  not  otherwise  possess  material  non-public  information  concerning  the  Company.  The  Board  of  Directors  authorized  20,000  shares  to  be
made available for purchase by officers and directors under the ODPP. Effective on August 28, 2019 and March 10, 2020, the Board of Directors approved an
additional  40,000  and  125,000  shares,  respectively,  to  be  made  available  under  the  ODPP.  Common  stock  issued  under  the  ODPP  during  the  year  ended
December 31, 2020 totaled 53,034 shares. As of December 31, 2020, there were 92,170 shares reserved for issuance under the ODPP.

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ITEM 12.    SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS

Equity Compensation Plan Information

All of our equity compensation plans have been approved by our stockholders.  The following table provides information as of December 31, 2020, with

respect to the shares of our common stock that may be issued under our existing equity compensation plans.

(a) Number of
Securities to be
Issued Upon
Exercise of
Outstanding
Options,
Restricted
Stock Units and
Rights

(b) Weighted
Average
Exercise
Price of
Outstanding
Options,
Restricted
Stock Units and
Rights (2)

(c) Number of
Securities
Remaining
Available for
Future Issuance
Under Equity
Compensation
Plans
(Excluding
Securities
Reflected in
Column (a))

419,463    $

1,241.59     

225,048 

Plan Category
Equity compensation plans approved by stockholders (1)

(1) Includes the following plans: our 2009 Stock Plan and our 2015 Plan.  Our 2015 Plan provides that on the first day of each fiscal year commencing in fiscal
year 2016, the number of shares authorized for issuance under the 2015 Plan is automatically increased by a number equal to the lesser of (i) 4,225 shares
of common stock, (ii) 5.0% of the aggregate number of shares of common stock outstanding on the last day of the preceding fiscal year, or (iii) such number
of shares that may be determined by our board of directors.  

(2) The weighted average exercise price does not take into account outstanding restricted stock, or RSUs, which have no exercise price.

Security Ownership of Certain Beneficial Owners and Management

The following table sets forth certain information with respect to the beneficial ownership of our capital stock as of December 31, 2020 for:

•

•

•

•

each person or group of affiliated persons known by us to be the beneficial owner of more than 5% of our common stock;

each of our named executive officers;

each of our directors and nominees for director; and

all of our current executive officers and directors as a group.

We have determined beneficial ownership in accordance with the rules and regulations of the SEC, and the information is not necessarily indicative of
beneficial ownership for any other purpose.  Except as indicated by the footnotes below, we believe, based on information furnished to us, that the persons and
entities named in the table below have sole voting and sole investment power with respect to all shares of our capital stock that they beneficially own, subject to
applicable community property laws.

Applicable percentage ownership is based on 84,926,129 shares of our common stock outstanding as of December 31, 2020. In computing the number
of shares of capital stock beneficially owned by a person and the percentage ownership of such person, we deemed to be outstanding all shares of our capital
stock subject to options held by the person that are currently exercisable or exercisable within 60 days of December 31, 2020.  However, we did not deem such
shares of our capital stock outstanding for the purpose of computing the percentage ownership of any other person.

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Unless  otherwise  indicated,  the  address  of  each  beneficial  owner  listed  in  the  table  below  is  c/o  Avinger,  Inc.,  400  Chesapeake  Drive,  Redwood  City,
California  94063.  The  information  provided  in  the  table  is  based  on  our  records,  information  filed  with  the  SEC  and  information  provided  to  us,  except  where
otherwise noted.

Name of Beneficial Owner

Named Executive Officers and Directors:

Jeffrey M. Soinski(1)
Himanshu Patel(2)
Mark Weinswig(3)
James G. Cullen(4)
James B. McElwee(5)
Tamara N. Elias
All executive officers, directors and director nominees as a group (6 individuals)(6)

Shares Beneficially Owned

Number of
Shares

Percentage

76,580     
264,035     
55,382     
73,465     
70,142     
-     
539,604     

* 
* 
* 
* 
* 
* 
* 

* Represents ownership of less than 1%
(1) Consists  of  (i)  74,738  shares  of  common  stock  held  of  record  by  Mr.  Soinski,  and  (ii)  1,842  shares  of  common  stock  issuable  upon  exercise  of  options

exercisable within 60 days of December 31, 2020.

(2) Consists  of  (i)  58,409  shares  of  common  stock  held  of  record  by  Mr.  Patel,  (ii)  warrants  to  purchase  5,000  shares  of  common  stock,  (iii)  626  shares  of
common  stock  issuable  upon  exercise  of  options  exercisable  within  60  days  of  December  31,  2020,  and  (iv)  200,000  shares  of  common  stock  that  are
issuable upon the conversion of shares of Series B preferred stock that are immediately convertible to common stock.

(3) Consists of 55,382 shares of common stock held of record by Mr. Weinswig.
(4) Consists of (i) 69,852 shares of common stock held of record by 2000 James Cullen Generation Skipping Family Trust, (ii) 184 shares of common stock held
by Gilbert Investments, LLC and (iii) 3,429 shares of common stock issuable upon exercise of options exercisable within 60 days of December 31, 2020. Mr.
Cullen  has  sole  voting  and  dispositive  power  with  respect  to  shares  held  by  Gilbert  Investments,  LLC  and  James  Cullen  Generation  Skipping  Family
Trust.    Mr.  Cullen  does  not  have  a  pecuniary  interest  in  the  James  Cullen  Generation  Skipping  Family  Trust  and  disclaims  beneficial  ownership  in  Gilbert
Investments, LLC except to the extent of his pecuniary interest therein.

(5) Consists  of  (i)  69,856  shares  of  common  stock  held  of  record  by  Mr.  McElwee,  and  (ii)  286  shares  of  common  stock  issuable  upon  exercise  of  options

exercisable within 60 days of December 31, 2020.

(6) Consists of (i) 328,421 shares of common stock, (ii) warrants to purchase 5,000 shares of common stock, (iii) 6,183 shares of common stock issuable upon
exercise  of  options  exercisable  within  60  days  of  December  31,  2020  and  (iv)  200,000  shares  of  common  stock  that  are  issuable  upon  the  conversion  of
shares of Series B preferred stock that are immediately convertible to common stock.

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ITEM 13.    CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE

Related Person Transactions

We describe below transactions and series of similar transactions, since the beginning of our last fiscal year, to which we were a party or will be a party,

in which:

•

•

the amounts involved exceeded or will exceed $120,000; and

any of our directors, nominees for director, executive officers or beneficial holders of more than 5% of our outstanding common stock, or any
immediate family member of, or person sharing the household with, any of these individuals or entities (each, a related person), had or will have a
direct or indirect material interest.

We  have  entered  into  employment  and  separation  arrangements  with  certain  current  and  former  executive  officers.    For  more  information  on  these

employment and separation agreements, see the section titled “Executive Employment Letters” in Item 11 above.

We have entered into indemnification agreements with our directors and executive officers.  The indemnification agreements, as well as our certificate of

incorporation and bylaws, require us to indemnify our directors and executive officers to the fullest extent permitted by Delaware law.

Policies and Procedures for Related Party Transactions

Our board of directors has adopted a written policy that our executive officers, directors, nominees for election as a director, beneficial owners of more
than 5% of any class of our common stock and any members of the immediate family of any of the foregoing persons are not permitted to enter into a related
person  transaction  with  us  without  the  prior  consent  of  our  audit  committee.    Any  request  for  us  to  enter  into  a  transaction  with  an  executive  officer,  director,
nominee for election as a director, beneficial owner of more than 5% of any class of our common stock or any member of the immediate family of any of the
foregoing persons in which the amount involved exceeds $120,000 and such person would have a direct or indirect interest must first be presented to our audit
committee  for  review,  consideration  and  approval.    In  approving  or  rejecting  any  such  proposal,  our  audit  committee  is  to  consider  the  material  facts  of  the
transaction, including, but not limited to, whether the transaction is on terms no less favorable than terms generally available to an unaffiliated third-party under
the same or similar circumstances and the extent of the related person’s interest in the transaction.

Director Independence

Information  regarding  the  independence  of  directors  is  disclosed  above  under  Item  10  under  the  heading  “Director  Independence”  and  incorporated  herein  by
reference.

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ITEM 14.    PRINCIPAL ACCOUNTANT FEES AND SERVICES

Fees Paid to the Independent Registered Public Accounting Firm

The following table represents aggregate fees billed to us for the years ended December 31, 2020 and 2019 by Moss Adams, as applicable.  All fees

below were approved by our Audit Committee.

Year ending December 31,
Audit fees(1)(2)
Audit related fees
Tax fees

Total

2020

2019

  $

  $

629,041    $
14,450     
—     
643,491    $

469,832 
13,650 
— 
483,482 

(1)

(2)

Audit fees consist of fees incurred for professional services rendered for the audit of our annual financial statements and review of the quarterly financial
statements, assistance with registration statements filed with the SEC, and services that are normally provided by our independent registered public
accounting firm in connection with regulatory filings or engagements.  
For the years ended December 31, 2020 and 2019, audit fees also include fees related to our public offerings and review of documents filed with the SEC of
$281,491 and $95,045, respectively.

Auditor Independence

In  our  fiscal  year  ended  December  31,  2020,  there  were  no  other  professional  services  provided  by  Moss  Adams  that  would  have  required  our  audit

committee to consider their compatibility with maintaining the independence of Moss Adams.

Audit Committee Policy on Pre-Approval of Audit and Permissible Non-Audit Services of Independent Registered Public Accounting Firm

Our audit committee has established a policy governing our use of the services of our independent registered public accounting firm.  Under this policy,
our audit committee is required to pre-approve all audit and non-audit services performed by our independent registered public accounting firm in order to ensure
that the provision of such services does not impair the public accountants’ independence.  All fees paid to Moss Adams for our fiscal years ended December 31,
2020 and 2019 were pre-approved by our audit committee.

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ITEM 15.    EXHIBITS AND FINANCIAL STATEMENT SCHEDULES

(a)(1) Financial Statements

The following Financial Statements are filed as part of this Annual Report on Form 10-K:

PART IV

Report of Independent Registered Public Accounting Firm
Financial Statements
Balance Sheets
Statements of Operations and Comprehensive Loss
Statements of Stockholders’ Equity (Deficit)
Statements of Cash Flows
Notes to Financial Statements

(a)(2) Financial Statement Schedules

F-2

F-4
F-5
F-6
F-7
F-8

All other schedules have been omitted because the information required to be set forth therein is not applicable or is shown in the financial statements or

notes thereto. Financial statement schedules relating to the allowance for doubtful accounts receivable and for sales returns follows (in thousands):

Description
Allowance for doubtful accounts receivable:

Fiscal year ended 2019
Fiscal year ended 2020

Allowance for sales returns:

Fiscal year ended 2019
Fiscal year ended 2020

Balance at
Beginning
of Year

Charged to
costs and
expenses

    Write offs

Balance at
End of
Year

  $
  $

  $
  $

260    $
19    $

(56)   $
26    $

185    $
26    $

Balance at
Beginning
of Year

Charged to
costs and
expenses

10    $
6    $

81

Write offs

17    $
29    $

21    $
15    $

Balance at
End of
Year

19 
19 

6 
20 

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
   
 
     
 
       
     
 
 
 
 
 
   
   
   
 
   
 
     
 
       
     
 
 
 
 
(a)(3) Exhibits

The following exhibits are filed as part of, or incorporated by reference into, this Annual Report on Form 10-K.

Exhibit
Number
3.1 (1)
3.2 (1)
3.3 (2)
3.4 (3)
3.5 (4)
3.6 (5)
3.7 (5)
3.8 (6)
4.1 (7)
4.2 (5)
4.3 (8)
4.4 (9)
4.5 (10)
10.1 (11)
10.2 (12)
10.3 (12)
10.4 (13)
10.5 (11)
10.6 (11)
10.7 (11)
10.8 (11)
10.9 (12)

Exhibit Title

  Amended and Restated Certificate of Incorporation of the registrant.
  Bylaws of the registrant.
  Certificate of Amendment to the Amended and Restated Certificate of Incorporation.
  Avinger, Inc. Certificate of Designation of Preferences, Rights and Limitations of Series  A Convertible Preferred Stock
  Avinger, Inc. Certificate of Designation of Preferences, Rights and Limitations of Series  B Convertible Preferred Stock
  Avinger, Inc. Certificate of Designation of Preferences, Rights and Limitations of Series C Convertible Preferred Stock
  Certificate of Amendment to the Certificate of Designation of Preferences, Rights and Limitations of Series A Convertible Preferred Stock
  Certificate of Amendment to the Restated Certificate of Incorporation of Avinger, Inc.
  Specimen Common Stock certificate of the registrant.
  Specimen Series 1/2 warrant of the registrant.
  Specimen Common Stock certificate of the registrant.
  Specimen Series 1/2 warrant of the registrant.
  Description of Registrant’s Securities
  Form of Indemnification Agreement for directors and executive officers.

2009 Stock Plan and Form of Option Agreement thereunder.
2014 Preferred Stock Plan.
2015 Equity Incentive Plan, as amended

  Form of Restricted Stock Unit Award Agreement.
  Form of Stock Option Agreement.

2015 Employee Stock Purchase Plan.
  Executive Incentive Compensation Plan.
  Amended and Restated Investors ’ Rights Agreement dated September  2, 2014 by and among the registrant and certain stockholders.

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Exhibit
Number
10.10 (12)

10.11 (12)
10.12 (15)
10.13 (12)
10.14 (12)
10.15 (12)
10.16 (16)
10.17 (4)

10.18 (12)
10.19 (12)

10.20 (14)

10.21 (14)

10.23 (15)
10.24 (17)
10.26 (18)
10.27 (19)
10.28 (4)
10.29 (4)

10.30 (20)

10.31 (21)
10.32 (21)
10.33 (21)
10.34 (21)
10.35 (22)
10.36 (23)
10.37 (24)
10.38 (25)
10.39 (26)
10.40 (10) 
10.41 (10)
10.42 (10)

10.43 (10)

Exhibit Title
Lease Agreement, dated July  30, 2010, by and between the registrant and HCP LS Redwood City, LLC for office space located at 400 and 600
Chesapeake Drive, Redwood City, California.

  First Amendment to Lease Agreement dated September  30, 2011 by and between registrant and HCP LS Redwood City, LLC.
  Second Amendment to Lease Agreement dated March  4, 2016 by and between the registrant and HCP LS Redwood City, LLC.
  Employment Letter dated December 29, 2010 by and between the registrant and Matthew B. Ferguson.
  Employment Letter dated December 17, 2014 by and between the registrant and Jeffrey M. Soinski.
  Change of Control and Severance Agreement dated March  1, 2012 by and between the registrant and Matthew  B. Ferguson.
  Change of Control and Severance Agreement dated March  29, 2018 by and between the registrant and Jeffrey M. Soinski.

Registration Rights Agreement, dated as of February    , 2018, by and among the registrant, CRG Partners III L.P. and certain of its affiliated
funds, as purchasers.

  Note and Warrant Purchase Agreement dated October  29, 2013 by and between the registrant and holders of convertible promissory notes.

Amendment No. 1 to the Note and Warrant Purchase Agreement dated May  6, 2014 by and between the registrant and holders of convertible
promissory notes.
Term Loan Agreement, dated as of September  22, 2015, by and among the registrant, certain of its subsidiaries from time to time party thereto
as guarantors and CRG Partners III L.P. and certain of its affiliated funds, as lenders.
Securities Purchase Agreement, dated as of September  22, 2015, by and among the registrant, CRG Partners III L.P. and certain of its affiliated
funds, as purchasers.

  Purchase Agreement, dated as of November  3, 2017, by and between the registrant and Lincoln Park Capital Fund, LLC.
  Registration Rights Agreement, dated as of November  3, 2017, by and between the registrant and Lincoln Park Capital Fund, LLC.
  Waiver and Consent, dated as of December  14, 2017, by and among the registrant and the lenders party thereto.
  Waiver and Consent, dated as of January  24, 2018, by and among the registrant and the lenders party thereto.
  Amendment No. 2 to Term Loan Agreement, dated as of February  14, 2018, by and among the registrant and the lenders party thereto.

Series A Preferred Stock Purchase Agreement, dated as of February  14, 2018, by and among the registrant, CRG Partners III L.P. and certain of
its affiliated funds, as purchasers.
Securities Purchase Agreement, dated as of July 12, 2018, by and among the registrant and the purchasers identified on the signature pages
thereto.

  Separation Agreement and Release, dated as of August 1, 2018, between the registrant and Matt Ferguson.  
  Master Consulting Agreement, dated as of August 1, 2018, between the registrant and Matt Ferguson.  
  Employment Offer Letter, dated as of June 11, 2018, between the registrant and Mark Weinswig.
  Change of Control and Severance Agreement, dated as of June 25, 2018, between the registrant and Mark Weinswig.
  Officer and Director Share Purchase Plan.
  Change of Control and Severance Agreement, dated as of October 10, 2013, between the registrant and Himanshu Patel.
  Third Amendment to Lease Agreement dated April 1, 2019 by and between the registrant and HCP LS Redwood City, LLC.
  Amended and Restated 2015 Equity Incentive Plan
  Amended and Restated Officer and Director Share Purchase Plan
  Amendment No. 1 to Amended and Restated Officer and Director Share Purchase Plan
  Amendment No. 3 to Term Loan Agreement dated as of March 2, 2020, by and among the registrant and the lenders party thereto

Amendment No. 1 dated March 4, 2020 to the Change of Control and Severance Agreement, dated March 29, 2018, by and between the
registrant and Jeff Soinski
Amendment No. 1 dated March 4, 2020 to the Change of Control and Severance Agreement, dated October 10, 2013, by and between the
registrant and Himanshu Patel

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10.44 (10)

10.45 (27)
10.46 (28)
10.47 (29)

23.1
24.1
31.1

31.2

32.1

Amendment No. 1 dated March 4, 2020 to the Change of Control and Severance Agreement, dated June 25, 2018, by and between the registrant
and Mark Weinswig

  Promissory Note dated April 20, 2020 between Avinger, Inc. and Silicon Valley Bank
  Amendment No. 4 and Waiver to Term Loan Agreement

Amendment No. 5 to Term Loan Agreement, dated January 22, 2021, made by and among Avinger, Inc. and GRG Partners III L.P. and certain of
its affiliated funds, as lenders.

  Consent of Independent Registered Public Accounting Firm.
  Power of Attorney (included on signature page).

Certification of the Chief Executive Officer pursuant to Securities Exchange Act Rules  13a-14(a) and 15d-14(a), as adopted pursuant to
Section 302 of the Sarbanes-Oxley Act of 2002.
Certification of the Chief Financial Officer pursuant to Securities Exchange Act Rules  13a-14(a) and 15d-14(a), as adopted pursuant to
Section 302 of the Sarbanes-Oxley Act of 2002.
Certifications of the Chief Executive Officer and Chief Financial Officer pursuant to 18 U.S.C. Section  1350, as adopted pursuant to Section  906
of the Sarbanes-Oxley Act of 2002.

101.INS
101.SCH
101.CAL
101.DEF
101.LAB
101.PRE

  XBRL Instance Document
  XBRL Taxonomy Extension Schema Document
  XBRL Taxonomy Extension Calculation Linkbase Document
  XBRL Taxonomy Extension Definition Linkbase Document
  XBRL Taxonomy Extension Label Linkbase Document
  XBRL Taxonomy Extension Presentation Linkbase Document

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15)

Previously filed as an Exhibit to the Current Report on Form 8-K filed with the Securities and Exchange Commission on February 6,
2015, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
February 2, 2018.
Previously filed as an Exhibit to Amendment No. 2 to the registrant’s Registration Statement on Form S-1 (File No. 333-222517) filed
with the Securities and Exchange Commission on February 12, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to Amendment No. 3 to the registrant’s Registration Statement on Form S-1 (File No. 333-222517) filed
with the Securities and Exchange Commission on February 13, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
November 6, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Current Report on Form 8-K filed with the Securities and Exchange Commission on
June 21, 2019, and incorporated by reference herein.
Previously filed as an Exhibit to Amendment No. 2 to the registrant’s Registration Statement on Form S-1 (File No. 333-201322) filed
with the Securities and Exchange Commission on January 28, 2015, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
July 13, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to Amendment No. 1 to the registrant’s Registration Statement on Form S-1 (File No. 333-227689) filed
with the Securities and Exchange Commission on October 19, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on
March 6, 2020, and incorporated by reference herein.
Previously filed as an Exhibit to Amendment No. 1 to the registrant’s Registration Statement on Form S-1 (File No. 333-201322) filed
with the Securities and Exchange Commission on January 20, 2015, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Registration Statement on Form S-1 (File No. 333-201322), filed with the Securities
and Exchange Commission on December 30, 2014, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on
August 13, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
November 12, 2015, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on
March 8, 2016, and incorporated by reference herein.

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(16)

(17)

(18)

(19)

(20)

(21)

(22)

(23)

(24)

(25)

(26)

(27)

(28)

(29)

Previously filed as an Exhibit to the registrant’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on
March 30, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Registration Statement on Form S-1 (File No. 333-221368), filed with the Securities
and Exchange Commission on November 6, 2017, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
December 14, 2017, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
January 30, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
July 13, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on
August 13, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Current Report on Form 8-K filed with the Securities and Exchange Commission on
August 24, 2018, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on
March 6, 2019, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Current Report on Form 8-K filed with the Securities and Exchange Commission on
April 5, 2019, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on
August 8, 2019, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on
November 5, 2019, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Current Report on Form 8-K filed with the Securities and Exchange Commission on
April 24, 2020, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on
May 13, 2020, and incorporated by reference herein.
Previously filed as an Exhibit to the registrant's Current Report on Form 8-K filed with the Securities and Exchange Commission on
January 26, 2021, and incorporated by reference herein.

ITEM 16.     FORM 10-K SUMMARY

None.

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AVINGER, INC.

INDEX TO FINANCIAL STATEMENTS
As of December 31, 2020 and 2019, and the

Years Ended December 31, 2020 and 2019

Report of Independent Registered Public Accounting Firm
Financial Statements:
Balance Sheets
Statements of Operations and Comprehensive Loss
Statements of Stockholders’ Equity
Statements of Cash Flows
Notes to Financial Statements

F-1

F-2

F-4
F-5
F-6
F-7
F-8

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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Stockholders and the Board of Directors of
Avinger, Inc.

Opinion on the Financial Statements

We have audited the accompanying balance sheets of Avinger, Inc. (the “Company”) as of December 31, 2020 and 2019, the related statements of operations
and  comprehensive  loss,  stockholders’  equity,  and  cash  flows  for  the  years  then  ended,  the  related  notes  and  the  financial  statement  schedules  (collectively
referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of
December 31, 2020 and 2019, and the results of its operations and its cash flows for the years then ended, in conformity with accounting principles generally
accepted in the United States of America.

Basis for Opinion

These  financial  statements  are  the  responsibility  of  the  Company’s  management.  Our  responsibility  is  to  express  an  opinion  on  the  Company’s  financial
statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and
are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the
Securities and Exchange Commission and the PCAOB.

We  conducted  our  audits  in  accordance  with  the  standards  of  the  PCAOB.  Those  standards  require  that  we  plan  and  perform  the  audit  to  obtain  reasonable
assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor
were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of internal
control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting.
Accordingly, we express no such opinion.

Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing
procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial
statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall
presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.

Critical Audit Matter

The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be
communicated to the audit committee and that (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially
challenging,  subjective,  or  complex  judgments.  The  communication  of  critical  audit  matters  does  not  alter  in  any  way  our  opinion  on  the  financial  statements,
taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or
disclosures to which it relates.

Valuation of Inventories

As described in Note 1 and 4 to the financial statements, the Company’s inventories balance was $3.9 million as of December 31, 2020. The Company values its
inventories  at  lower  of  cost  (determined  using  the  first-in,  first-out  method)  or  net  realizable  value.  The  Company  writes  down  inventory  that  has  expired  or
become obsolete, inventory that has a cost basis in excess of its expected net realizable value, and inventory in excess of expected requirements. The estimate
of excess quantities is subjective and primarily dependent on the estimates of future demand for a particular product. Changes in assumptions of product demand
could  have  a  significant  impact  on  the  amount  of  write-down  recorded.  The  evaluation  by  management  includes  analysis  of  historical  sales  levels  by  product,
projections of future demand, the risk of technological or competitive obsolescence for products, general market conditions, as well as the feasibility of reworking
or  using  excess  or  obsolete  products  or  components  in  the  production  or  assembly  of  other  products  that  are  not  obsolete  or  for  which  there  are  not  excess
quantities in inventory.

F-2

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We identified the valuation of inventories, in particular the estimates for excess quantities and obsolescence, as a critical audit matter, because of the significant
assumptions and subjective judgments used by management, which in turn led to the use of subjective auditor judgment and audit effort to address the matter.

The primary procedures we performed to address the critical audit matter included:

•

Evaluating management’s process for developing the estimates of excess and obsolete inventories by:

•

•

Evaluating the methodology utilized to calculate the write-downs, and

Testing the mathematical accuracy and the appropriateness of the formulaic calculation.

•

Evaluating the reasonableness of the significant assumptions used by management including those related to future demand by:

•

•

Evaluating management’s ability to provide reasonable forecast of sales by comparing prior period sales forecasts to actual results, and

Performing inquiries with nonfinancial personnel, including sales and production employees, regarding obsolete or discontinued inventory items and
other factors to corroborate management’s assertions regarding qualitative judgments about excess and obsolete inventories.

•

Testing the completeness, accuracy, and relevance of the underlying data used in management’s estimate and calculations related to the application of
the methodology to specific inventory categories.

/s/ Moss Adams LLP

San Francisco, California
March 11, 2021

We have served as the Company’s auditor since 2017.

F-3

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AVINGER, INC.
BALANCE SHEETS
(In thousands, except share and per share data)

Assets
Current assets:

Cash and cash equivalents
Accounts receivable, net of allowance for doubtful accounts of $19 at both December 31, 2020 and 2019
Inventories
Prepaid expenses and other current assets

  $

Total current assets

Right of use asset
Property and equipment, net
Other assets

Total assets

Liabilities and stockholders’ equity
Current liabilities:

Accounts payable
Accrued compensation
Accrued expenses and other current liabilities
Leasehold liability, current portion
Borrowings, current portion

Total current liabilities

Leasehold liability, long-term portion
Borrowings, long-term portion
Other long-term liabilities

Total liabilities

Commitments and contingencies (Note 9)

Stockholders’ equity:

  $

  $

December 31,
2020

December 31,
2019

22,185    $
1,484     
3,876     
350     
27,895     

4,063     
727     
510     
33,195    $

694    $
1,703     
669     
806     
3,590     
7,462     

3,257     
9,400     
—     
20,119     

10,943 
1,458 
3,912 
311 
16,624 

4,856 
1,661 
684 
23,825 

663 
1,782 
654 
722 
8,967 
12,788 

4,135 
— 
7 
16,930 

Convertible preferred stock issuable in series, par value of $0.001
Shares authorized: 5,000,000 at December 31, 2020 and 2019
Shares issued and outstanding: 52,369 and 48,503 at December 31, 2020 and 2019, respectively; aggregate
liquidation preference related to Series A convertible preferred stock of $52,191 and $48,325 at December
31, 2020 and 2019, respectively
Common stock, par value of $0.001

Shares authorized: 100,000,000 at December 31, 2020 and 2019
Shares issued and outstanding: 84,926,129 and 10,364,663 at December 31, 2020 and 2019, respectively

Additional paid-in capital
Accumulated deficit

Total stockholders’ equity

Total liabilities and stockholders’ equity

—     

— 

85     
380,332     
(367,341)    
13,076     
33,195    $

10 
355,220 
(348,335)
6,895 
23,825 

  $

See accompanying notes.

F-4

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AVINGER, INC.
STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
(In thousands, except per share data)

Revenues
Cost of revenues
Gross profit

Operating expenses:

Research and development
Selling, general and administrative

Total operating expenses

Loss from operations

Interest income
Interest expense
Other income, net
Net loss and comprehensive loss
Accretion of preferred stock dividends

Net loss applicable to common stockholders
Net loss per share attributable to common stockholders, basic and diluted

Weighted average common shares used to compute net loss per share, basic and diluted

See accompanying notes.

F-5

  $

  $
  $

Year Ended December 31,

2020

2019

8,761    $
6,143     
2,618     

5,695     
14,327     
20,022     
(17,404)    

34     
(1,692)    
56     
(19,006)    
(3,866)    
(22,872)   $
(0.46)   $

49,231     

9,131 
6,264 
2,867 

5,692 
16,534 
22,226 
(19,359)

288 
(1,480)
1,101 
(19,450)
(3,580)
(23,030)

(3.18)

7,239 

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
   
 
   
   
 
     
       
 
     
       
 
   
   
   
   
 
     
       
 
   
   
   
   
   
 
     
       
 
   
 
 
AVINGER, INC.
STATEMENTS OF STOCKHOLDERS ’ EQUITY
(In thousands, except share data)

Convertible
Preferred Stock

Common Stock

Balance at December 31, 2018

Issuance of common stock under officers
and directors purchase plan and vesting
of restricted stock units

Employee stock-based compensation
Exercise of warrants for common stock
Issuance of common stock in August

public offerings, net of commissions and
issuance costs

Issuance of Series A preferred stock to

Shares    

Amount

45,671    $

Shares
—      3,492,200    $

Amount

Additional
Paid-
In Capital

Accumulated
Deficit

Total
Stockholders’
Equity

3    $

338,342    $

(328,885)   $

9,460 

—     
—     
—     

137,575     
—     
—     
—     
—      1,998,079     

—     
—     
2     

72     
2,091     
7,991     

—     
—     
—     

72 
2,091 
7,993 

—     

—      3,813,559     

4     

3,807     

—     

3,811 

pay dividends

6,525     

—     

—     

—     

6,498     

—     

6,498 

Conversion of Series B preferred stock

into common stock

(1,523)    

—     

380,750     

—     

—     

Conversion of Series C preferred stock

into common stock

Accretion of Series A preferred stock

dividends

Net and comprehensive loss
Balance at December 31, 2019

Issuance of common stock in public
offerings, net of commissions and
issuance costs

Employee stock-based compensation
Issuance of common stock under officers
and directors purchase plan and vesting
of restricted stock units

Issuance of Series A preferred stock to

pay dividends

Accretion of Series A preferred stock

dividends

Net and comprehensive loss

Balance at December 31, 2020

—     

—     

— 

— 

(2,170)    

—     

542,500     

1     

(1)    

—     
—     
48,503     

—     
—     
—     
—     
—      10,364,663     

—     
—     
10     

(3,580)    
—     
355,220     

—     
(19,450)    
(348,335)    

(3,580)
(19,450)
6,895 

—     
—     

—      74,140,297     
—     
—     

74     
—     

23,572     
1,513     

—     
—     

23,646 
1,513 

—     

—     

421,169     

1     

27     

—     

28 

3,866     

—     

—     

—     

3,866     

—     

3,866 

—     
—     
52,369    $

—     
—     
—     
—     
—      84,926,129    $

—     
—     
85    $

(3,866)    
—     
380,332    $

—     
(19,006)    
(367,341)   $

(3,866)
(19,006)
13,076 

See accompanying notes.

F-6

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
   
     
 
     
 
   
 
 
 
 
   
   
   
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
Year Ended December 31,
2019
2020

  $

(19,006)   $

(19,450)

897     
168     
1,513     
1,524     
169     
528     
(54)    

(1)    
(490)    
(48)    
5     
31     
(79)    
15     
(7)    
(14,835)    

—     
65     
65     

2,330     
36     
—     
23,646     
26,012     

11,242     
10,943     
22,185    $

3,866    $
3,866    $
(169)   $
—    $
(1)   $

890 
171 
2,091 
1,309 
(462)
272 
(51)

(248)
(1,169)
128 
(16)
(485)
585 
(795)
(34)
(17,264)

(88)
18 
(70)

— 
63 
7,993 
3,811 
11,867 

(5,467)
16,410 
10,943 

6,498 
3,580 

462 
4,680 

408 

AVINGER, INC.
STATEMENTS OF CASH FLOWS
(In thousands)

Cash flows from operating activities

Net loss
Adjustments to reconcile net loss to net cash used in operating activities:

Depreciation and amortization
Amortization of debt issuance costs and debt discount
Stock-based compensation
Noncash interest expense and other charges
Change in right of use asset
Provision for excess and obsolete inventories
Other non-cash charges
Changes in operating assets and liabilities:

Accounts receivable
Inventories
Prepaid expenses and other current assets
Other assets
Accounts payable
Accrued compensation
Accrued expenses and other current liabilities
Other long-term liabilities

Net cash used in operating activities

Cash flows from investing activities
Purchase of property and equipment
Proceeds from sale of property and equipment

Net cash provided by (used in) investing activities

Cash flows from financing activities

Proceeds from borrowings
Proceeds from issuance of common stock under officers’ and directors’ purchase plan
Proceeds from exercise of common stock warrants
Proceeds from the issuance of common stock in public offerings, net

Net cash provided by financing activities

Net change in cash and cash equivalents
Cash and cash equivalents, beginning of period
Cash and cash equivalents, end of period

Supplemental disclosure of cash flow information

Noncash investing and financing activities:

Issuance of Series A preferred stock as dividend payment
Accretion of Series A preferred stock dividends

Reclassification of right of use asset to prepaid rent
Increase to right of use asset and leasehold liability arising from lease amendment

Transfer between inventory and property and equipment

See accompanying notes.

F-7

  $

  $
  $
  $
  $
  $

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
   
 
     
       
 
     
       
 
   
   
   
   
   
   
   
     
       
 
   
   
   
   
   
   
   
   
   
 
     
       
 
     
       
 
   
   
   
 
     
       
 
     
       
 
   
   
   
   
   
 
     
       
 
   
   
 
     
       
 
     
       
 
 
     
       
 
     
       
 
 
     
       
 
 
 
AVINGER, INC.

Notes to Financial Statements

1. Organization

Organization, Nature of Business

Avinger, Inc. (the “Company”), a Delaware corporation, was incorporated in March 2007. The Company designs, manufactures and sells image-guided,
catheter-based systems that are used by physicians to treat patients with peripheral artery disease (“PAD”). Patients with PAD have a build-up of plaque in the
arteries that supply blood to areas away from the heart, particularly the pelvis and legs. The Company manufactures and sells a suite of products in the United
States  (“U.S.”)  and  in  select  international  markets.  The  Company  has  developed  its  Lumivascular  platform,  which  integrates  optical  coherence  tomography
(“OCT”) visualization with interventional catheters and is the industry’s only system that provides real-time intravascular imaging during the treatment portion of
PAD  procedures.  The  Company’s  Lumivascular  platform  consists  of  a  capital  component,  our  Lightbox  console,  as  well  as  a  variety  of  disposable  catheter
products. The Company’s current products include its non-imaging catheters, Wildcat and Kittycat 2, as well as its Lumivascular platform products, Ocelot, Ocelot
PIXL, Ocelot MVRX and Tigereye, all of which are designed to allow physicians to penetrate a total blockage in an artery, known as a chronic total occlusion
(“CTO”). The Company also has image-guided atherectomy solutions under its suite of Lumivascular products, Pantheris and Pantheris SV, which are designed
to allow physicians to precisely remove arterial plaque in PAD patients. The Company is located in Redwood City, California.

Liquidity Matters

In the course of its activities, the Company has incurred losses and negative cash flows from operations since its inception. As of December 31, 2020,
the Company had an accumulated deficit of $367.3 million. The Company expects to incur losses for the foreseeable future. The Company believes that its cash
and cash equivalents of $22.2 million at December 31, 2020, together with the approximately $13.0 million net proceeds from the February 2021 equity financing,
and expected revenues and funds from operations will be sufficient to allow the Company to fund its current operations through 2022. We received net proceeds
of approximately $8.0 million from the issuance of common stock upon the exercise of warrants during March and April of 2019, net proceeds of $3.8 million from
the  sales  of  our  common  stock  in  our  August  2019  offering,  $3.9  million  from  the  sale  of  our  common  stock  in  our  January  2020  offering,  $2.3  million  of  loan
proceeds  in  April  2020  pursuant  to  the  Paycheck  Protection  Program  (“PPP”)  under  the  Coronavirus  Aid,  Relief  and  Economic  Security  (“CARES”)  Act,  $3.0
million from the sale of our common stock in April and May 2020, $5.5 million from the sale of our common stock in June and July 2020, $11.3 million from the
sale of our common stock in August and September 2020, and approximately $13.0 million from the sale of our common stock in February 2021, the Company
does not have any immediate plans to raise additional funds through future equity or debt financings. However, the Company may decide to raise additional funds
to meet its operational needs and capital requirements for product development, clinical trials and commercialization or other strategic objectives.

The Company can provide no assurance that it will be successful in raising funds pursuant to additional equity or debt financings or that such funds will
be raised at prices that do not create substantial dilution for our existing stockholders. Given the volatility in the Company’s stock price, any financing that we may
undertake in the next twelve months could cause substantial dilution to our existing stockholders, there can be no assurance that the Company will be successful
in  acquiring  additional  funding  at  levels  sufficient  to  fund  its  various  endeavors.  In  addition,  the  COVID-19  pandemic  and  responses  thereto  have  resulted  in
reduced consumer and investor confidence, instability in the credit and financial markets, volatile corporate profits, restrictions on elective medical procedures,
and reduced business and consumer spending, which could increase the cost of capital and/or limit the availability of capital to the Company. During the second
quarter  of  2020  we  took  certain  actions  to  manage  available  cash  and  other  resources  to  mitigate  the  effects  of  COVID-19  on  our  business,  which  included
reduction of discretionary costs, reduction of base salaries for all our non-manufacturing employees by 20% and reduction of hours worked by our manufacturing
workers  by  20%.  While  salaries  and  hours  worked  largely  returned  to  levels  prior  to  July  2020,  we  will  continue  to  employ  certain  actions  to  manage  our
resources  in  the  foreseeable  future.  There  can  be  no  assurance  that  such  strategies  will  be  successful  in  mitigating  the  negative  impacts  of  the  COVID-19
pandemic on our business.

If the Company is unable to raise additional capital in sufficient amounts or on terms acceptable to it, the Company may have to significantly reduce its
operations  or  delay,  scale  back  or  discontinue  the  development  of  one  or  more  of  its  products.  The  financial  statements  do  not  include  any  adjustments  that
might  result  from  the  outcome  of  this  uncertainty.  The  Company’s  ultimate  success  will  largely  depend  on  its  continued  development  of  innovative  medical
technologies, its ability to successfully commercialize its products and its ability to raise significant additional funding.

F-8

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
Public Offerings

On March 7, 2019, we filed a universal shelf registration statement (the “Shelf Registration Statement”) to offer up to $50.0 million of our securities. We
have established, and may in the future establish, “at-the-market” programs pursuant to which we may offer and sell shares of our common stock pursuant to the
Shelf Registration Statement. Due to the SEC’s “baby shelf rules,” which prohibit companies with a public float of less than $75 million from issuing securities
under  a  shelf  registration  statement  in  excess  of  one-third  of  such  company’s  public  float  in  a  twelve-month  period,  we  may  only  be  able  to  issue  a  limited
number of shares using the Shelf Registration Statement.

On  August  26,  2019,  we  completed  a  public  offering  of  3,813,559  shares  of  common  stock  at  an  offering  price  of  $1.18  per  share.  As  a  result,  we
received  net  proceeds  of  approximately  $3.8  million  after  underwriting  discounts,  commissions,  legal  and  accounting  fees  and  the  conversion  price  of  the
outstanding shares of Series B preferred stock, issued in our February 2018 offering, was reduced to $1.18 per share as a result. 

On  January  31,  2020,  we  completed  a  public  offering  of  6,428,572  shares  of  common  stock  at  an  offering  price  of  $0.70  per  share.  As  a  result,  we
received net proceeds of approximately $3.9 million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses. Due to
anti-dilution provisions, the conversion price of the outstanding shares of Series B preferred stock, which was issued in our February 2018 offering, was reduced
to $0.70 per share.

On April 30, 2020, we completed a public offering of 12,600,000 shares of common stock at an offering price of $0.25 per share. On May 6, 2020 we
issued an additional 1,890,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection  with  the  aforementioned  offering.  As  a  result,  we  received  aggregate  net  proceeds  of  approximately  $3.0  million  after  underwriting  discounts,
commissions, legal and accounting fees, and other ancillary expenses. Due to anti-dilution provisions, the conversion price of the outstanding shares of Series B
preferred stock, which was issued in our February 2018 offering, was reduced to $0.25 per share.

On June 26, 2020, we completed a public offering of 20,000,000 shares of common stock at an offering price of $0.27 per share. On July 9, 2020 we
issued an additional 3,000,000 shares of common stock at the same offering price pursuant to the exercise in full of the underwriter’s over-allotment option in
connection with the aforementioned offering resulting in $0.7 million of additional net proceeds. As a result, we received aggregate net proceeds of approximately
$5.5 million including the overallotment option and after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 6, 2020, under the Shelf Registration Statement, we completed a public offering of 15,789,474 shares of common stock at an offering price of
$0.38 per share. On August 11, 2020 we issued an additional 2,368,421 shares of common stock at the same offering price pursuant to the exercise in full of the
underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $6.2 million
after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On August 25, 2020, under the Shelf Registration Statement, we completed a public offering of 11,063,830 shares of common stock at an offering price
of $0.47 per share. On September 1, 2020 we issued an additional 1,000,000 shares of common stock at the same offering price pursuant to the exercise in full
of the underwriter’s over-allotment option in connection with the aforementioned offering. As a result, we received aggregate net proceeds of approximately $5.1
million after underwriting discounts, commissions, legal and accounting fees, and other ancillary expenses.

On February 2, 2021, under the Shelf Registration Statement, we completed a bought deal offering of 10,000,000 shares of common stock at an offering
price of $1.44 per share. As a result, we received aggregate net proceeds of approximately $13.0 million after underwriting discounts, commissions, legal and
accounting fees, and other ancillary expenses.

2. Summary of Significant Accounting Policies

Basis of Presentation

The accompanying financial statements have been prepared in accordance with United States generally accepted accounting principles (“U.S. GAAP”)

and pursuant to the rules and regulations of the SEC (“SEC”).

On June 19, 2019, the Company’s Board of Directors approved an amendment to the Company’s amended and restated certificate of incorporation to
effect a 1-for-10 reverse stock split of the Company’s common stock. The reverse stock split became effective on June 21, 2019. The par values of the common
stock and convertible preferred stock were not adjusted as a result of the reverse stock splits. All common stock, stock options, and restricted stock units, and per
share amounts in the financial statements for all periods presented reflect the reverse stock split.

F-9

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts
and  disclosures  reported  in  the  financial  statements.  Management  uses  significant  judgment  when  making  estimates  related  to  its  stock-based  compensation,
accruals related to compensation, the valuation of the common stock warrants, provisions for doubtful accounts receivable and excess and obsolete inventories,
clinical  trial  accruals,  and  its  reserves  for  sales  returns  and  warranty  costs.  Management  bases  its  estimates  on  historical  experience  and  on  various  other
assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of
assets and liabilities that are not readily apparent from other sources. Although these estimates are based on the Company’s knowledge of current events and
actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions.

Fair Value of Financial Instruments

The  Company  has  evaluated  the  estimated  fair  value  of  its  financial  instruments  as  of  December  31,  2020  and  2019.  Financial  instruments  consist  of
cash and cash equivalents, accounts receivable and payable, and other current liabilities and borrowings. The carrying amounts of cash and cash equivalents,
accounts  receivable  and  payable,  and  other  current  liabilities  approximate  their  respective  fair  values  because  of  the  short-term  nature  of  those  instruments.
Based upon the borrowing terms and conditions currently available to the Company, the carrying values of the borrowings approximate their fair value.

Cash and Cash Equivalents

The  Company  considers  all  highly  liquid  investments  with  an  original  maturity  of  three  months  or  less  at  the  time  of  purchase  to  be  cash  equivalents.
Cash equivalents are considered available-for-sale marketable securities and are recorded at fair value, based on quoted market prices. As of December 31, 2020
and 2019, the Company’s cash equivalents are entirely comprised of investments in money market funds. Any related unrealized gains and losses are recorded
in  other  comprehensive  income  (loss)  and  included  as  a  separate  component  of  stockholders’  equity.  There  were  no  unrealized  gains  and  losses  as  of
December  31,  2020  and  2019.  Any  realized  gains  and  losses  and  interest  and  dividends  on  available-for-sale  securities  are  included  in  interest  income  or
expense and computed using the specific identification cost method.

Concentration of Credit Risk, and Other Risks and Uncertainties

Financial instruments that potentially subject the Company to credit risk consist of cash and cash equivalents and accounts receivable to the extent of the

amounts recorded on the balance sheets.

The  Company’s  policy  is  to  invest  in  cash  and  cash  equivalents,  consisting  of  money  market  funds.  These  financial  instruments  are  held  in  Company
accounts at one financial institution. The counterparties to the agreements relating to the Company’s investments consist of financial institutions of high credit
standing. The Company provides for uncollectible amounts when specific credit problems arise. Management’s estimates for uncollectible amounts have been
adequate, and management believes that all significant credit risks have been identified at December 31, 2020 and 2019.

The  Company’s  accounts  receivable  are  due  from  a  variety  of  healthcare  organizations  in  the  United  States  and  select  international  markets.  At
December 31, 2020, there was one customer that represented 14% of accounts receivable. At December 31, 2019, no customer represented 10% or more of the
Company’s  accounts  receivable.  For  the  years  ended  December  31,  2020  and  2019,  there  were  no  customers  that  represented  10%  or  more  of  revenues.
Disruption of sales orders or a deterioration of financial condition of its customers would have a negative impact on the Company’s financial position and results of
operations.

The Company manufactures its commercial products in-house, including the Pantheris and Ocelot family of catheters. Certain of the Company’s product
components and sub-assemblies continue to be manufactured by sole suppliers, including internally. Disruption in component or sub-assembly supply from these
manufacturers or from in-house production would have a negative impact on the Company’s financial position and results of operations.

The  Company  is  subject  to  certain  risks,  including  that  its  devices  may  not  be  approved  or  cleared  for  marketing  by  governmental  authorities  or  be
successfully  marketed.  There  can  be  no  assurance  that  the  Company’s  products  will  achieve  widespread  adoption  in  the  marketplace,  nor  can  there  be  any
assurance that existing devices or any future devices can be developed or manufactured at an acceptable cost and with appropriate performance characteristics.
The  Company  is  also  subject  to  risks  common  to  companies  in  the  medical  device  industry,  including,  but  not  limited  to,  new  technological  innovations,
dependence upon third-party payors to provide adequate coverage and reimbursement, dependence on key personnel and suppliers, protection of proprietary
technology, product liability claims, and compliance with government regulations.

F-10

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Existing or future devices developed by the Company may require approvals or clearances from the FDA or international regulatory agencies. In addition,
in order to continue the Company’s operations, compliance with various federal and state laws is required. If the Company were denied or delayed in receiving
such approvals or clearances, it may be necessary to adjust operations to align with the Company’s currently approved portfolio. If clearance for the products in
the current portfolio were withdrawn by the FDA, this may have a material adverse impact on the Company.

Accounts Receivable

Trade  accounts  receivable  are  recorded  at  the  invoiced  amount  and  do  not  bear  interest.  The  allowance  for  doubtful  accounts  is  the  Company’s  best
estimate of the amount of probable credit losses in the Company’s existing accounts receivable. The Company determines the allowance for doubtful accounts
based  upon  an  aging  of  accounts  receivable,  historical  experience,  and  management  judgment.  Accounts  receivable  balances  are  reviewed  individually  for
collectability.  To  date,  the  Company  has  not  experienced  significant  credit-related  losses.  Accounts  receivable  provision  and  recoveries  or  write-offs  are
summarized as follows (in thousands):

Beginning balance

Provision
Recoveries/write-offs

Ending balance

Inventories

2020

2019

19    $
26     
(26)    
19    $

260 
(56)
(185)
19 

  $

  $

Inventories are valued at the lower of cost or net realizable value. Cost is determined using the first-in, first-out method for all inventories. The Company’s
policy is to write down inventory that has expired or become obsolete, inventory that has a cost basis in excess of its expected net realizable value, and inventory
in excess of expected requirements. At each balance sheet date, management evaluates inventories for excess quantities, and obsolescence. This evaluation by
management  includes  analysis  of  historical  sales  levels  by  product,  projections  of  future  demand,  the  risk  of  technological  or  competitive  obsolescence  for
products, general market conditions, as well as the feasibility of reworking or using excess or obsolete products or components in the production or assembly of
other products that are not obsolete or for which there are not excess quantities in inventory. To the extent that management determines there are excess or
obsolete inventory, management adjusts the carrying value to estimated net realizable value. When quantities on hand exceed sales forecasts, a write-down is
recorded  for  such  excess  inventories  along  with  a  corresponding  charge  to  cost  of  revenues.  The  estimate  of  excess  quantities  is  subjective  and  primarily
dependent on the estimates of future demand for a particular product. Changes in assumptions of product demand could have a significant impact on the amount
of write-down recorded. Inventory used in clinical trials is expensed at the time of production and recorded as research and development expense.

Property and Equipment

Property and equipment are recorded at cost. Repairs and maintenance costs are expensed as incurred. Depreciation and amortization are calculated
using  the  straight-line  method  over  the  estimated  useful  lives  of  the  assets  of  generally  three  to  five  years.  Depreciation  expense  includes  the  amortization  of
assets acquired under capital leases and equipment located at customer sites. Equipment held by customers is comprised of the Lightbox consoles located at
customer sites under a lease or placement agreement. Upon execution of a lease or placement agreement, the related equipment is reclassified from inventory to
the  property  and  equipment  account.  Depreciation  expense  for  equipment  held  by  customers  is  recorded  as  a  component  of  cost  of  revenues.  Leasehold
improvements  and  assets  recorded  under  capital  leases  are  amortized  using  the  straight-line  method  over  the  shorter  of  the  lease  term  or  estimated  useful
economic life of the asset.

Impairment of Long-Lived Assets

The  Company  reviews  long-lived  assets,  including  property  and  equipment,  for  impairment  whenever  events  or  changes  in  business  circumstances
indicate  that  the  carrying  amount  of  the  assets  may  not  be  fully  recoverable.  If  indicators  of  impairment  exist,  an  impairment  loss  would  be  recognized  when
estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition are less than its carrying amount. Impairment, if
any, is measured as the amount by which the carrying amount of the long-lived asset exceeds its fair value. The Company has not recorded any impairment of
long-lived assets since inception through December 31, 2020.

F-11

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
   
 
   
   
 
 
 
 
 
 
 
Revenue Recognition

The Company’s revenues are derived from (1) sale of Lightbox consoles, (2) sale of disposables, which consist of catheters and accessories, and (3) sale
of  customer  service  contracts  and  maintenance.  The  Company  sells  its  products  directly  to  hospitals  and  medical  centers  as  well  as  through  distributors.  The
Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties
are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company’s revenues are measured based
on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government
authorities. For all sales, the Company uses either a signed agreement or a binding purchase order as evidence of an arrangement. The Company’s revenue
recognition policies generally result in revenue recognition at the following points:

1.

2.

3.

Lightbox console sales: Provided all other criteria for revenue recognition have been met, the Company recognizes revenue for Lightbox console
sales directly to end customers when delivery and acceptance occurs, which is defined as receipt by the Company of an executed form that the
installation process is complete.

Sales of disposables: Disposable revenues consist of sales of the Company’s catheters and accessories and are recognized when the product
has shipped, risk of loss and title has passed to the customer and collectability is reasonably assured.

Service  revenue:  Service  contract  revenue  consists  of  preventative  maintenance,  upgrades,  and  service  contracts.  Service  contracts  are
recognized ratably over the term of the service period and maintenance contract revenue is recognized as work is performed. To date, service
revenue has been insignificant.

The Company offers its customers the ability to purchase or lease the Lightbox console. In addition, the Company provides a Lightbox under a limited
commercial evaluation program to allow accounts to install and utilize the Lightbox for a limited trial period. When a Lightbox is placed under a lease agreement or
under  a  commercial  evaluation  program,  the  Company  retains  title  to  the  equipment  and  it  remains  capitalized  on  its  balance  sheet  under  property  and
equipment.  Depreciation  expense  on  these  placed  Lightboxes  is  recorded  to  cost  of  revenues  on  a  straight-line  basis.  The  costs  to  maintain  these  placed
Lightboxes are charged to cost of revenues as incurred.

The Company evaluates its lease and commercial evaluation program agreements and accounts for these contracts under the guidance in Accounting
Standards Codification (“ASC”) 842, Leases and ASU No. 2014 09,  Revenue from Contracts with Customers (Topic 606) . The guidance requires arrangement
consideration to be allocated between a lease deliverable and a non-lease deliverable based upon the relative selling-price of the deliverables.

The Company assessed whether the embedded lease is an operating lease or sales-type lease. Based on the Company’s assessment of the guidance
and given that any payments under the lease agreements are dependent upon contingent future sales, it was determined that collectability of the minimum lease
payments is not reasonably predictable. Accordingly, the Company concluded the embedded lease did not meet the criteria of a sales-type lease and accounts
for  it  as  an  operating  lease.  The  Company  recognizes  revenue  allocated  to  the  lease  as  the  contingent  disposable  product  purchases  are  delivered  and  are
included in revenues within the statement of operations and comprehensive loss.

For  sales  through  distributors,  the  Company  recognizes  revenue  when  control  of  the  product  transfers  from  the  Company  to  the  distributor.  The
distributors  are  responsible  for  all  marketing,  sales,  training  and  warranty  in  their  respective  territories.  The  standard  terms  and  conditions  contained  in  the
Company’s distribution agreements do not provide price protection or stock rotation rights to any of its distributors. In addition, its distributor agreements do not
allow the distributor to return or exchange products, and the distributor is obligated to pay the Company upon invoice regardless of its ability to resell the product.

Cost of Revenues

Cost  of  revenues  consists  primarily  of  manufacturing  overhead  costs,  material  costs  and  direct  labor.  A  significant  portion  of  the  Company’s  cost  of
revenues  currently  consists  of  manufacturing  overhead  costs.  These  overhead  costs  include  the  cost  of  quality  assurance,  material  procurement,  inventory
control, facilities, equipment and operations supervision and management. Cost of revenues also includes depreciation expense for the Lightboxes under lease
and evaluation agreements, product warranty costs, product written-off due to excess or obsolescence, and certain direct costs such as shipping costs.

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Product Warranty Costs

The Company typically offers a one-year warranty on its products commencing upon the transfer of title and risk of loss to the customer. The Company
accrues for the estimated cost of product warranties upon invoicing its customers, based on historical results. Warranty costs are reflected in the statement of
operations and comprehensive loss as a cost of revenues. The warranty obligation is affected by product failure rates, material usage and service delivery costs
incurred in correcting a product failure. Should actual product failure rates, material usage or service delivery costs differ from these estimates, revisions to the
estimated warranty liability would be required. Periodically the Company assesses the adequacy of its recorded warranty liabilities and adjusts the amounts as
necessary. Warranty provisions and claims are summarized as follows (in thousands):

Beginning balance

Warranty provision
Usage/Release

Ending balance

Research and Development

2020

2019

215    $
142     
(164)    
193    $

272 
71 
(128)
215 

  $

  $

The  Company  expenses  research  and  development  costs  as  incurred.  Research  and  development  expenses  include  personnel  and  personnel-related
costs, costs associated with pre-clinical and clinical development activities, and costs for prototype products that are manufactured prior to market approval for
that  prototype  product,  and  internal  and  external  costs  associated  with  the  Company’s  regulatory  compliance,  including  the  costs  of  outside  consultants  and
contractors that assist in the process of submitting and maintaining regulatory filings, and overhead costs, including allocated facility and related expenses.

Clinical Trials

The  Company  accrues  and  expenses  costs  for  its  clinical  trial  activities  performed  by  third  parties,  including  clinical  research  organizations  and  other
service providers, based upon estimates of the work completed over the life of the individual study in accordance with associated agreements. The Company
determines these estimates through discussion with internal personnel and outside service providers as to progress or stage of completion of trials or services
pursuant to contracts with clinical research organizations and other service providers and the agreed-upon fee to be paid for such services.

Stock-Based Compensation

Stock-based  compensation  for  the  Company  includes  amortization  related  to  all  stock  options,  restricted  stock  units  (“RSU”),  based  on  the  grant-date
estimated fair value. The fair value of stock options is estimated on the date of grant using the Black-Scholes option pricing model and recognized as expense on
a  straight-line  basis  over  the  vesting  period  of  the  award.  The  Company  measures  the  fair  value  of  RSUs  using  the  closing  stock  price  of  a  share  of  the
Company’s common stock on the grant date and is recognized as expense on a straight-line basis over the vesting period of the award. As allowed under ASU
No.  2016‑09, Compensation-Stock  Compensation  (Topic  718):  Improvements  to  Employee  Share-Based  Payment  Accounting,  the  Company  accounts  for
forfeitures as they occur.

Foreign Currency

The Company records net gains and losses resulting from foreign exchange transactions as a component of foreign currency exchange losses in other
income (expense), net. During the years ended December 31, 2020 and 2019, the Company recorded $18,000 and $11,000 of foreign currency exchange net
(gains)/losses, respectively.

Income Taxes

The Company utilizes the liability method of accounting for income taxes. Under this method, deferred tax assets and liabilities are determined based on
differences between financial reporting and tax reporting bases of assets and liabilities and are measured using enacted tax rates and laws that are expected to be
in  effect  when  the  differences  are  expected  to  reverse.  Valuation  allowances  are  established  when  necessary  to  reduce  deferred  tax  assets  to  the  amounts
expected to be realized. The Company’s policy is to record interest and penalties on uncertain tax positions as income tax expense when they occur. During the
years ended December 31, 2020 and 2019, the Company did not recognize accrued interest or penalties related to unrecognized tax benefits.

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Net Loss per Share Attributable to Common Stockholders

Basic net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted
average number of shares of common stock outstanding during the period, without consideration for potential dilutive common shares. Diluted net loss per share
attributable  to  common  stockholders  is  computed  by  dividing  the  net  loss  attributable  to  common  stockholder  by  the  weighted  average  number  of  shares  of
common stock and dilutive potential shares of common stock outstanding during the period. Any common stock shares subject to repurchase are excluded from
the calculations as the continued vesting of such shares is contingent upon the holders’ continued service to the Company. As of December 31, 2020 and 2019,
there  were  no  shares  subject  to  repurchase.  Since  the  Company  was  in  a  loss  position  for  both  periods  presented,  basic  net  loss  per  share  attributable  to
common stockholders is the same as diluted net loss per share attributable to common stockholders as the inclusion of all potentially dilutive common shares
would have been anti-dilutive.

Net loss per share attributable to common stockholders was determined as follows (in thousands, except per share data):

Net loss attributable to common stockholders
Weighted average common stock outstanding, basic and diluted

Net loss per share attributable to common stockholders, basic and diluted

  $

  $

(22,872)   $
49,231     
(0.46)   $

(23,030)
7,239 

(3.18)

Year Ended December 31,
2019
2020

The  following  potentially  dilutive  securities  outstanding  have  been  excluded  from  the  computations  of  diluted  weighted  average  shares  outstanding

because such securities have an anti-dilutive impact due to losses reported:

Common stock warrant equivalents
Common stock options
Convertible preferred stock
Unvested restricted stock units

Comprehensive Loss

Year Ended December 31,
2020

2019

2,753,999     
7,029     
48,503     
719,418     
3,528,949     

3,197,208 
7,549 
45,015 
471,252 
3,721,024 

For the years ended December 31, 2020 and 2019, there was no difference between comprehensive loss and the Company’s net loss.

Segment and Geographical Information

The  Company  operates  and  manages  its  business  as  one  reportable  and  operating  segment.  The  Company’s  chief  executive  officer,  who  is  the  chief
operating  decision  maker,  reviews  financial  information  on  an  aggregate  basis  for  purposes  of  allocating  resources  and  evaluating  financial  performance.
Primarily  all  of  the  Company’s  long-lived  assets,  which  are  comprised  of  property  and  equipment,  are  based  in  the  United  States.  For  the  years  ended
December 31, 2020 and 2019, 94% and 93%, respectively, of the Company’s revenues were in the United States, based on the shipping location of the external
customer.

Recent Accounting Pronouncements

Recently adopted accounting standards

In June 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2016-13,  Financial  Instruments –  Credit
Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which changes the methodology to be used to measure credit losses for certain
financial instruments and financial assets, including trade receivables.  The new methodology requires the recognition of an allowance that reflects the current
estimate of credit losses expected to be incurred over the life of the financial asset.  The new standard became effective for the Company in the first quarter of
2020. The adoption of this standard did not have a material impact on the Company’s financial statements.

F-14

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Recent accounting standards not yet adopted as of December 31, 2020

In December 2019, the FASB issued ASU 2019-12,  Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes , which among other things,
eliminates certain exceptions in the current rules regarding the approach for intraperiod tax allocations and the methodology for calculating income taxes in an
interim period, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill.  The standard was adopted by the Company on
January 1, 2021. This new standard did not have a material impact on the Company’s financial statements.

In  August  2020,  the  FASB  issued  ASU  2020-06,  Debt—Debt  with  Conversion  and  Other  Options  (Subtopic  470-20)  and  Derivatives  and
Hedging—Contracts in Entity ’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity ’s  Own  Equity ,  which  among
other  things,  simplifies  the  accounting  models  for  the  allocation  of  proceeds  attributable  to  the  issuance  of  a  convertible  debt  instrument.    As  a  result,  after
adopting  the  ASU’s  guidance,  entities  will  not  separately  present  in  equity  an  embedded  conversion  feature  in  such  debt.  Instead,  they  will  account  for  a
convertible debt instrument wholly as debt, and for convertible preferred stock wholly as preferred stock (i.e., as a single unit of account), unless (i) a convertible
instrument contains features that require bifurcation as a derivative under ASC 815 or (ii) a convertible debt instrument was issued at a substantial premium. The
standard becomes effective for the Company in the first quarter of 2022 and early adoption is permitted.  This new standard is not expected to have a material
impact on the Company’s financial statements.

3. Fair Value Measurements

The Company measures certain financial assets and liabilities at fair value on a recurring basis. Fair value is an exit price, representing the amount that
would  be  received  to  sell  an  asset  or  paid  to  transfer  a  liability  in  an  orderly  transaction  between  market  participants.  As  such,  fair  value  is  a  market-based
measurement  that  should  be  determined  based  on  assumptions  that  market  participants  would  use  in  pricing  an  asset  or  a  liability.  A  three-tier  fair  value
hierarchy is established as a basis for considering such assumptions and for inputs used in the valuation methodologies in measuring fair value:

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Inputs other than quoted prices included within Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets
or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially
the full term of the assets or liabilities.

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.

As of December 31, 2020 and 2019, cash equivalents were all categorized as Level 1 and consisted of money market funds. As of December 31, 2020
and 2019, there were no financial assets and liabilities categorized as Level 2 or Level 3. There were no transfers between fair value hierarchy levels during the
years ended December 31, 2020 and 2019.

4. Inventories

Inventories consisted of the following (in thousands):

Raw materials
Work-in-process
Finished products

Total inventories

December 31,

2020

2019

1,904    $
180     
1,792     
3,876    $

1,426 
596 
1,890 
3,912 

  $

  $

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EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
   
 
5. Property and Equipment, Net

Property and equipment, net, consisted of the following (in thousands):

Equipment held by customers
Machinery and equipment
Computer software
Computer equipment
Furniture and fixture
Leasehold improvements

Total property and equipment, gross

Less: Accumulated depreciation and amortization

Total property and equipment, net

December 31,

2020

2019

2,746    $
1,679     
122     
144     
78     
311     
5,080     
(4,353)    
727    $

3,076 
1,878 
122 
144 
78 
311 
5,609 
(3,948)
1,661 

  $

  $

Depreciation expense for the years ended December 31, 2020 and 2019, was approximately $896,000 and $890,000, respectively.

Property and equipment include certain equipment that is leased to customers and located at customer premises. The Company retains the ownership of
the equipment held for evaluation and has the right to remove the equipment if it is not being utilized according to expectations. Depreciation expense relating to
the leased equipment held by customers of $629,000 and $586,000 was recorded in cost of revenues during the years ended December 31, 2020 and 2019,
respectively. The net book value of this equipment was $518,000 and $1.2 million at December 31, 2020 and 2019, respectively.

6. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):

Accrued product warranty costs
Accrued clinical trial costs
Accrued professional fees
Accrued travel expenses
Accrued sales and use tax
Other accrued liabilities

Total accrued expenses and other current liabilities

7. Borrowings

CRG

December 31,

2020

2019

193    $
96     
65     
104     
43     
168     
669    $

215 
101 
30 
89 
18 
201 
654 

  $

  $

On  September  22,  2015,  the  Company  entered  into  a  Term  Loan  Agreement,  as  amended  (the  “Loan  Agreement”)  with  CRG  under  which,  subject  to
certain conditions, the Company had the right to borrow up to $50 million in principal amount from CRG on or before March 29, 2017. The Company borrowed
$30 million on September 22, 2015. The Company borrowed an additional $10 million on June 15, 2016 under the Loan Agreement.

On  February  14,  2018,  the  Company  and  CRG  further  amended  the  Loan  Agreement  concurrent  with  the  conversion  of  $38  million  of  the  principal
amount  of  the  senior  secured  term  loan  (plus  $3.8  million  in  back-end  fees  and  prepayment  premium  applicable  thereto)  into  a  newly  authorized  Series  A
convertible preferred stock (see below).

F-16

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On March 2, 2020, the Company entered into Amendment No. 3 to the Loan Agreement to, among other things:

•

•

•

•

extend the period that the Company can make interest payments in payment in kind (“PIK”) to June 30, 2021;

lower the Minimum Revenue Covenants to $10 million for 2020, $12 million for 2021, and $15 million for 2022;

insert certain terms to clarify that all fees, including the prepayment premium, are due if the obligations are accelerated; and

insert a new provision to make clear that to the extent the Company divides its assets/liabilities into divisions, such assets/liabilities will be treated
as transferred to a third party.

On May 12, 2020, the Company entered into Amendment No. 4 to the Loan Agreement to, among other things:

•

•

grant to the Company the right to optionally prepay in whole or in part the outstanding principal amount of the Loans for the Redemption Price,
subject to certain conditions; and

waive the Company’s requirement to comply with the Minimum Revenue Covenant for 2020.

On January 22, 2021, the Company entered into Amendment No. 5 to the Loan Agreement to, among other things:

•

•

•

•

•

extend the maturity date of the Loan Agreement from June 30, 2023 to December 31, 2025;

extend the interest only payment period and the period that the Company can make interest payments in PIK to December 31, 2023;

lowers the Minimum Revenue Covenants to $8 million and $10 million for 2021 and 2022, respectively and establishes revenue covenants of $12
million for 2023; $14.5 million for 2024, and $17 million for 2025;

change the date under the on-going stand-alone representation regarding no Material Adverse Change to December 31, 2020;

amend  the  on-going  stand-alone  representation  and  stand-alone  event  of  default  regarding  “Material  Adverse  Change”  such  that  any  adverse
change in or effect upon the revenue of the Company and its subsidiaries due to the outbreak of COVID-19 will not constitute a Material Adverse
Change

Under the amended Loan Agreement, no cash payments for either principal or interest are due until the first quarter of 2024. The interest will be accrued
and  included  in  the  debt  balance  based  (to  the  extent  not  paid)  on  principal  amounts  outstanding  at  the  beginning  of  the  quarter  at  an  interest  rate  of  12.5%.
Beginning  in  the  first  quarter  of  2024,  the  Company  will  be  required  to  make  quarterly  principal  payments  (in  addition  to  the  interest)  of  $1.9  million  with  total
principal payments of $7.5 million in 2024 and $7.5 million in 2025. The maturity date of the Loan is December 31, 2025.

The Company may voluntarily prepay the borrowings in full, with a prepayment premium beginning at 5.0% and declining by 1.0% annually thereafter,
with no premium being payable if prepayment occurs after seven and half years of the loan. Each tranche of borrowing required the payment, on the borrowing
date, of a financing fee equal to 1.5% of the borrowed loan principal, which is recorded as a discount to the debt. In addition, a facility fee equal to 15.0% of the
amounts borrowed plus any payment-in-kind (“PIK”) is to be payable at the end of the term or when the borrowings are repaid in full. A long-term liability is being
accreted using the effective interest method for the facility fee over the term of the Loan Agreement with a corresponding discount to the debt. The borrowings
are collateralized by a security interest in substantially all of the Company’s assets.

The Loan Agreement requires that the Company adheres to certain affirmative and negative covenants, including financial reporting requirements, certain
minimum  financial  covenants  for  pre-specified  liquidity  and  revenue  requirements  and  a  prohibition  against  the  incurrence  of  indebtedness,  or  creation  of
additional liens, other than as specifically permitted by the terms of the Loan Agreement. In particular, the covenants of the amended Loan Agreement included a
covenant  that  the  Company  maintain  a  minimum  of  $3.5  million  of  cash  and  certain  cash  equivalents,  and  the  Company  has  to  achieve  certain  minimum
revenues.  If  the  Company  fails  to  meet  the  applicable  minimum  revenue  target  in  any  calendar  year,  the  Loan  Agreement  provides  the  Company  with  a  cure
right if it prepays a portion of the outstanding principal equal to 2.0 times the revenue shortfall. In addition, the Loan Agreement prohibits the payment of cash
dividends on the Company’s capital stock and also places restrictions on mergers, sales of assets, investments, incurrence of liens, incurrence of indebtedness
and transactions with affiliates. CRG may accelerate the payment terms of the Loan Agreement upon the occurrence of certain events of default set forth therein,
which  include  the  failure  of  the  Company  to  make  timely  payments  of  amounts  due  under  the  Loan  Agreement,  the  failure  of  the  Company  to  adhere  to  the
covenants set forth in the Loan Agreement, the insolvency of the Company or upon the occurrence of a material adverse change.

F-17

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As of December 31, 2020, the Company was in compliance with all applicable covenants under the Loan Agreement.

As of December 31, 2020, principal, final facility fee and PIK payments under the Loan Agreement, which incorporates all amendments occurring prior to

our fiscal year end, were as follows (in thousands):

Year Ending December 31,
2021
2022
2023
Total
Less: Amount of PIK additions and facility fee to be accreted subsequent to December 31, 2020
Less: Amount representing debt financing costs

Borrowings, as of December 31, 2020

  $

  $

3,400 
6,266 
4,518 
14,184 
(3,122)
(418)
10,644 

In  connection  with  drawdowns  under  the  Loan  Agreement,  the  Company  recorded  aggregate  debt  discounts  of  $1.3  million  as  contra-debt.  The  debt
discounts are being amortized as non-cash interest expense using the effective interest method over the term of the Loan Agreement. As of December 31, 2020
and 2019, the balance of the aggregate debt discount was approximately $418,000 and $588,000, respectively. The Company’s interest expense associated with
the amortization of debt discount was approximately $169,000 during both the years ended December 31, 2020 and 2019. The Company incurred total interest
expense of approximately $1.5 million during both the years ended December 31, 2020 and 2019. 

Amendment  No.  5  to  the  Loan  Agreement  resulted  in  the  changing  of  the  date  under  the  on-going  stand-alone  representation  regarding  no  “Material
Adverse  Change”  to  December  31,  2020  and  amended  the  on-going  stand-alone  representation  and  stand-alone  event  of  default  regarding  Material  Adverse
Change  such  that  any  adverse  change  in  or  effect  upon  the  revenue  of  the  Company  due  to  the  outbreak  of  COVID-19  will  not  constitute  a  Material  Adverse
Change. With the aforementioned changes in the Loan Agreement in place; the current compliance with all financial and other covenants and the high likelihood
of continued compliance, management believes there is a low likelihood of violating contractual commitments which would cause an event of default through a
material adverse change in the business or otherwise. As a result, the amounts related to the Loan Agreement have been bifurcated between current and non-
current based on the due date of contractual payments as of December 31, 2020.

As of December 31, 2020, approximately $1.9 million of borrowings was classified as current, with the remaining $8.7 million classified as non-current.

Approximately $169,000 and $249,000 of aggregate debt discount was included in the current and non-current amounts, respectively.

Paycheck Protection Program

On April 23, 2020, we received loan proceeds of $2.3 million (the “PPP Loan”) pursuant to the PPP under the CARES Act.

The Loan, which was in the form of a promissory note, dated April 20, 2020 (the “Promissory Note”), between the Company and Silicon Valley Bank as
the lender, matures on April 20, 2022 and bears interest at a fixed rate of 1% per annum, payable monthly commencing six months from the date of the Loan.
The Company may voluntarily prepay the borrowings in full with no associated penalty or premium.

Under the terms of the PPP, the principal may be forgiven if the Loan proceeds are used for qualifying expenses as described in the CARES Act, such
as payroll costs, benefits mortgage interest, rent, and utilities. No assurance can be provided that the Company will obtain forgiveness of the Loan in whole or in
part. In addition, details of the PPP continue to evolve regarding which companies are qualified to receive loans pursuant to the PPP and on what terms, and the
Company may be required to repay some or all of the Loan due to these changes or different interpretations of the PPP requirements.

The  Promissory  Note  evidencing  the  PPP  Loan  contains  customary  representations,  warranties,  and  covenants  for  this  type  of  transaction,  including
customary  events  of  default  relating  to,  among  other  things,  payment  defaults  and  breaches  of  representations  and  warranties  or  other  provisions  of  the
Promissory Note. The occurrence of an event of default may result in, among other things, the Company becoming obligated to repay all amounts outstanding.

F-18

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
     
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
On June 5, 2020, the President of the United States signed the Paycheck Protection Program Flexibility Act (the “PPPFA”) into law. The PPPFA gives
borrowers  of  a  PPP  loan  more  flexibility  and  time  to  spend  the  loan  proceeds  and  allows  the  funds  to  be  used  on  broader  categories  of  expenses  while  still
qualifying  for  loan  forgiveness.  We  applied  for  forgiveness  of  the  PPP  loan  in  the  fourth  quarter  of  2020.  While  we  believe  that  we  have  complied  with  the
requirements to obtain forgiveness, there can be no assurance that any or all of the PPP loan amount will be forgiven.

On December 27, 2020, the President of the United States signed the Consolidated Appropriations Act (the “CAA”), 2021 into law. The CAA provides,
among  other  things,  additional  funds  under  the  PPP  loan  program  which  can  demonstrate  revenue  reductions  of  25%  or  greater,  clarifies  tax  deductibility  of
expenses covered by forgiven loans, extension of paid sick leave and certain payroll tax deferral extensions. We also continue to evaluate and may still pursue
additional  programs  under  the  CARES  Act  or  the  Consolidated  Appropriations  Act,  but  there  is  no  guarantee  that  we  will  meet  any  eligibility  requirements  to
participate in such programs or, even if we are able to participate, that such programs will provide meaningful benefit to our business.

As of December 31, 2020, principal and interest payments due under the PPP Loan are as follows (in thousands):

Year Ending December 31,
2021
2022

Less: Amount of interest to be accreted subsequent to December 31, 2020

Borrowings, as of December 31, 2020

  $

  $

1,692 
673 
2,365 
(19)
2,346 

For the year ended December 31, 2020, the Company incurred interest expense of approximately $16,000 related to the PPP Loan.

8. Leases

The  Company’s  operating  lease  obligations  primarily  consist  of  leased  office,  laboratory,  and  manufacturing  space  under  a  non-cancelable  operating
lease that originally were to expire in November 2019. In addition to the minimum future lease commitments presented below, the lease requires the Company to
pay property taxes, insurance, maintenance, and repair costs. The lease includes a rent holiday concession and escalation clauses for increased rent over the
lease  term.  Rent  expense  is  recognized  using  the  straight-line  method  over  the  term  of  the  lease.  The  Company  records  deferred  rent  calculated  as  the
difference between rent expense and the cash rental payments.

On October 19, 2017, the Company entered into an agreement to sublease one of its facilities. The sublease agreement commenced on approximately
December 1, 2017 and expired on November 15, 2019 (which was 15 days prior to the expiration of the facility lease). The sublessee paid a base rent of $82,410
per month. In addition to the base rent, the sublessee paid the Landlord’s operating expenses and property taxes due and payable with respect to the subleased
facility.  We  recorded  $1.1  million  of  sublease  payments  received  in  other  income  on  the  statement  of  operations  and  comprehensive  loss  for  the  year  ended
December 31, 2019.

Upon the adoption of Topic 842 on January 1, 2019, the Company recognized a right of use asset and a corresponding leasehold liability related to this
lease of approximately $1.8 million, representing the present value of the remaining minimum lease payments as of that date. The asset was being reduced over
the remaining period of the lease on a straight-line basis. The leasehold liability is being reduced as payments are made.

On  April  1,  2019,  we  entered  into  an  amendment  to  the  lease  which  extended  the  lease  term  for  an  additional  period  of  five  years  subsequent  to  the
original expiration of November 30, 2019. As amended, the lease will expire on November 30, 2024. Under the terms of the amendment, we are obligated to pay
approximately  $5.8  million  in  base  rent  payments  through  November  2024,  beginning  on  December  1,  2019.  This  amendment  did  not  extend  the  term  of  the
lease with respect to the building being subleased. The weighted average remaining lease term as of December 31, 2020 is 3.9 years.

In connection with the amendment the Company adjusted its right-of-use asset and lease liability to $6.0 million. As of the date of the amendment, the
operating lease was included on the balance sheet at the present value of the future base payments discounted at a 6.5% discount rate using the rate of interest
that  the  Company  would  have  to  pay  to  borrow  on  a  collateralized  basis  over  a  similar  term  and  amount  equal  to  the  lease  payments  in  a  similar  economic
environment as the lease does provide an implicit rate.

F-19

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
     
 
   
 
   
   
 
 
 
 
 
 
 
 
 
Our  operating  lease  expense,  excluding  variable  maintenance  fees  and  other  expenses  on  a  monthly  basis,  is  approximately  $105,000.  For  the  year
ended December 31, 2020 and 2019, our rent expense totaled approximately $1.3 million and $1.4 million, respectively. Our variable expenses for both the years
ended December 31, 2020 and 2019 was approximately $0.2 million. Operating right-of-use asset amortization for the year ended December 31, 2020 and 2019
was approximately $964,000 and $676,000, respectively. Due to payments being made in excess of operating lease expense recognized, the Company recorded
approximately $291,000 and $461,000 as prepaid rent included in other assets on the balance sheet as of December 31, 2020 and 2019, respectively.

The following table presents the future operating lease payments and leasehold liability included on the balance sheet related to the Company’s operating

lease as of December 31, 2020 (in thousands):

Year Ending December 31,
2021
2022
2023
2024
Total
Less: Imputed interest
Leasehold liability as of December 31, 2020

9. Commitments and Contingencies

Purchase Obligations

  $

  $

1,123 
1,162 
1,203 
1,138 
4,626 
(563)
4,063 

Purchase  obligations  consist  of  agreements  to  purchase  goods  and  services  entered  into  in  the  ordinary  course  of  business.  The  Company  had  non-

cancelable commitments to suppliers for purchases totaling approximately $0.2 million as of December 31, 2020.

Indemnification

In the normal course of business, the Company enters into contracts and agreements that contain a variety of representations and warranties and may
provide  for  indemnification  of  the  counterparty.  The  Company’s  exposure  under  these  agreements  is  unknown  because  it  involves  claims  that  may  be  made
against it in the future, but have not yet been made. To date, the Company has not been subject to any claims or been required to defend any action related to its
indemnification obligations.

The Company indemnifies each of its directors and officers for certain events or occurrences, subject to certain limits, while the director is or was serving
at the Company’s request in such capacity, as permitted under Delaware law and in accordance with its certificate of incorporation and bylaws. The term of the
indemnification  period  lasts  as  long  as  a  director  may  be  subject  to  any  proceeding  arising  out  of  acts  or  omissions  of  such  director  in  such  capacity.  The
maximum  amount  of  potential  future  indemnification  is  unlimited;  however,  the  Company  currently  holds  director  liability  insurance.  This  insurance  allows  the
transfer of risk associated with the Company’s exposure and may enable it to recover a portion of any future amounts paid. The Company believes that the fair
value of these indemnification obligations is minimal. Accordingly, it has not recognized any liabilities relating to these obligations for any period presented.

Legal Proceedings

We are not involved in any pending legal proceedings that we believe could have a material adverse effect on our financial condition, results of operations
or cash flows. From time to time we may be involved in legal proceedings or investigations, which could harm our reputation, business and financial condition and
divert the attention of our management from the operation of our business.

F-20

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10. Stockholders’ Equity

Convertible Preferred Stock

As  of  December  31,  2020,  the  Company’s  certificate  of  incorporation,  as  amended  and  restated,  authorizes  the  Company  to  issue  up  to  5,000,000

shares of convertible preferred stock with $0.001 par value per share, of which 52,369 shares were issued and outstanding.

Series A Convertible Preferred Stock

On February 14, 2018, the Company entered into a Series A Purchase Agreement with CRG, pursuant to which it agreed to convert $38.0 million of the
outstanding  principal  amount  of  its  senior  secured  term  loan  (plus  $3.8  million  in  back-end  fees,  accrued  interest,  debt  discount  and  prepayment  premium
applicable thereto), totaling $41.8 million, into a newly authorized Series A convertible preferred stock (the “Series A preferred stock”). The Series A preferred
stock  was  initially  convertible  into  2,090,000  shares  of  common  stock  subject  to  certain  limitations  contained  in  the  Series  A  Purchase  Agreement.  Under  the
terms of the Series A Purchase Agreement, the holders of Series A preferred stock are entitled to receive annual accruing dividends at a rate of 8%, payable in
additional shares of Series A preferred stock or cash, at the Company’s option. The shares of Series A preferred stock have no voting rights and rank senior to all
other classes and series of the Company’s equity in terms of repayment and certain other rights. In January 2019, December 2019 and December 2020, 2,945,
3,580 and 3,866 additional shares, respectively, were issued to CRG as payment of dividends accrued through December 31, 2020. As of December 31, 2020,
52,191 shares of Series A preferred stock were outstanding. The Series A preferred stock accrued additional dividends of approximately $3.9 million and $3.6
million during the years ended December 31, 2020 and 2019, respectively.

Series B Convertible Preferred Stock

On February 16, 2018, the Company completed a public offering of 17,979 shares of Series B convertible preferred stock (the “Series B preferred stock”).
As  a  result,  the  Company  received  net  proceeds  of  approximately  $15.5  million  after  underwriting  discounts,  commissions,  legal  and  accounting  fees.  The
Series B preferred stock has a liquidation preference of $0.001 per share, full ratchet price based anti-dilution protection, has no voting rights and is subject to
certain  ownership  limitations.  The  Series  B  preferred  stock  is  immediately  convertible  at  the  option  of  the  holder,  has  no  stated  maturity,  and  does  not  pay
regularly stated dividends or interest. During the year ended December 31, 2019, 1,523 of these shares converted into 380,750 shares of common stock. As of
December 31, 2020, 178 shares of Series B preferred stock remained outstanding, which are currently convertible at $0.25 per share.

Series C Convertible Preferred Stock

On November 1, 2018, the Company completed a public offering of 728,500 shares of common stock and 8,586 shares of Series C convertible preferred
stock (the “Series C preferred stock”). As a result, we received net proceeds of approximately $10.2 million after underwriting discounts, commissions, legal and
accounting fees. Upon any dissolution, liquidation or winding up, whether voluntary or involuntary, holders of Series C preferred stock will be entitled to receive
distributions out of our assets, whether capital or surplus, of an amount equal to $0.001 per share of Series C preferred stock before any distributions shall be
made on the common stock but after distributions shall be made on any outstanding Series A preferred stock and any of our existing or future indebtedness. The
Series  C  preferred  stock  has  no  voting  rights.  During  the  year  ended  December  31,  2019,  all  2,170  of  these  shares  were  converted  into  542,500  shares  of
common stock, leaving no shares of Series C preferred stock outstanding.

Common Stock

At December 31, 2020, the Company’s certificate of incorporation, as amended and restated, authorizes the Company to issue up to 100,000,000 shares

of common stock with $0.001 par value per share, of which 84,926,129 shares were issued and outstanding.

F-21

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Common Stock Warrants

As of December 31, 2020, we had outstanding warrants to purchase common stock as follows:

Total
Outstanding
and
Exercisable

Underlying
Shares of
Common
Stock

Exercise
Price per
Share

Series 1 Warrants issued in February 2018 Series B
financing
Series 2 Warrants issued in February 2018 Series B
financing
Warrants issued in July 2018 financing
Warrants issued in November 2018 financing
Total

8,979,000     

897,900    $

8,709,500     
1,083,091     
8,768,395     
27,539,986     

870,950    $
108,309    $
876,840    $
2,753,999     

Expiration Date

20.00 

20.00 
15.80 
4.00 

February 2025

February 2025
July 2021
November 2023

In connection with the issuance of the Company’s Series E convertible preferred stock in September 2014 through January 2015, the Company issued
warrants to purchase an aggregate of up to the number of shares of common stock equal to 50% of the number of shares of the Company’s Series E Convertible
preferred stock purchased by such investor, all of which expired on September 2, 2019.

On  February  16,  2018,  in  connection  with  the  Company’s  completed  public  offering  of  Series  B  preferred  stock,  the  Company  issued  two  series  of
warrants that together provide for the purchase, by the investors in that offering, of an aggregate of 1,797,900 shares of common stock (the “Series B Warrants”).
Each share of Series B preferred stock is accompanied by one warrant to purchase one share of common stock at $20.00 per share that expires on the seventh
anniversary of the date of issuance to purchase up to 50 shares of common stock and one warrant that expires on the earlier of (i) the seventh anniversary of the
date of issuance or (ii) the 60th calendar day following the receipt and announcement of FDA clearance of the Company’s Pantheris below-the-knee device (or
the same or similar product with a different name) to purchase up to 50 shares of common stock; provided, however, if at any time during such 60-day period the
volume  weighted  average  price  for  any  trading  day  is  less  than  the  then  effective  exercise  price,  the  termination  date  shall  be  extended  to  the  seven  year
anniversary of the initial exercise date. FDA clearance of Pantheris SV was received in April 2019, triggering this 60-day period. During the entire 60-day period
following clearance, the volume weighted average price was less than the then effective exercise price. As such, all Series 2 warrants are currently deemed to
expire on the seventh anniversary of the date of issuance. The Company determined that the Series B Warrants should be classified as equity. As of December
31, 2020, Series B Warrants to purchase an aggregate of 1,768,850 shares of common stock remain outstanding.

On July 13, 2018, in connection with the Company’s completed public offering of 216,618 shares of common stock, the Company issued warrants that
provide for the purchase of 108,309 shares of common stock at $15.80 per share. Each share of common stock is accompanied by one half of one warrant that
expires on the third anniversary of the date of issuance. The Company determined that these warrants should be classified as equity. As of December 31, 2020,
all of these warrants remain outstanding.

On November 1, 2018, in connection with the Company’s completed public offering of 728,500 shares of common stock and 8,586 shares of Series C
convertible  preferred  stock,  the  Company  issued  warrants  to  provide  for  the  purchase  of  2,875,000  shares  of  common  stock.  Each  share  of  common  stock  is
accompanied by one warrant to purchase one share of common stock at $4.00 per share. These warrants expire on the 5th anniversary of the date of issuance.
Each share of preferred stock is accompanied by one warrant to purchase 250 shares of common stock. The Company determined that the warrants should be
classified as equity. During the year ended December 31, 2019, warrants were exercised for an aggregate of 1,998,079 shares of common stock with proceeds
to  the  Company  of  approximately  $8.0  million.  As  of  December  31,  2020,  warrants  to  purchase  an  aggregate  of  876,840  shares  of  common  stock  were
outstanding.

As of both December 31, 2020 and 2019, warrants to purchase an aggregate of 2,753,999 shares of common stock were outstanding.

F-22

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
   
   
 
   
   
   
   
   
    
 
 
 
 
 
 
Stock Plans

In January 2015, the Board of Directors adopted and the Company’s stockholders approved the 2015 Equity Incentive Plan (“2015 Plan”). The 2015 Plan
replaced the 2009 Stock Plan (the “2009 Plan”) which was terminated immediately prior to consummation of the Company’s IPO (collectively the “Plans.)” The
2015  Plan  provides  for  the  grant  of  incentive  stock  options  (“ISOs”)  to  employees  and  for  the  grant  of  non-statutory  stock  options  (“NSOs”),  restricted  stock,
restricted stock units (“RSUs”), stock appreciation rights, performance units and performance shares to employees, directors and consultants. Initially a total of
3,300 shares of common stock were reserved for issuance pursuant to the 2015 Plan. The shares reserved for issuance under the 2015 Plan included shares
reserved but not issued under the 2009 Plan, plus any share awards granted under the 2009 Plan that expire or terminate without having been exercised in full
or that are forfeited or repurchased. In addition, the number of shares available for issuance under the 2015 Plan includes an automatic annual increase on the
first day of each fiscal year beginning in fiscal 2016, equal to the lesser of 4,225 shares, 5.0% of the outstanding shares of common stock as of the last day of the
immediately  preceding  fiscal  year  or  an  amount  as  determined  by  the  Board  of  Directors.  In  addition,  during  fiscal  2018,  the  Board  of  Directors  approved  an
additional 300,000 shares of common stock for issuance under the 2015 Plan. The Company’s stockholders approved this increase on June 8, 2018. On June
19, 2019, the Company’s stockholders approved an additional 800,000 increase to the 2015 Plan. As of December 31, 2020, 225,048 shares were available for
grant under the 2015 Plan.

Pursuant to the Plans, ISOs and NSOs may be granted with exercise prices at not less than 100% of the fair value of the common stock on the date of
grant and the exercise price of ISOs granted to a stockholder, who, at the time of grant, owns stock representing more than 10% of the voting power of all classes
of the stock of the Company, shall be not less than 110% of the fair market value per share of common stock on the date of grant. The Company’s Board of
Directors determines the vesting schedule of the options. Options granted generally vest over four years and expire ten years from the date of grant.

Stock option activity under the Plans is set forth below:

Balance at December 31, 2018

Options expired
Options forfeited

Balance at December 31, 2019

Options expired
Options forfeited

Balance at December 31, 2020

Number of
Shares
(in
thousands)

Weighted
Average
Exercise
Price

Weighted
Average
Remaining
Contractual
Life
(in years)

Intrinsic
Value
(in
thousands)

7,954    $
(448)   $
(105)   $
7,401    $
(552)   $
(28)   $
6,821    $

1,707.30       
3,061.09     
1,929.52     
1,309.47     
2,129.17     
820.00     
1,241.59     

    $

6.81    $

5.81    $

Exercisable at December 31, 2020

6,802    $

1,242.76     

5.81    $

Vested and expected to vest at December 31, 2020

6,821    $

1,241.59     

5.81    $

Additional information related to the status of options as of December 31, 2020 is summarized as follows:

Options Outstanding

Options Vested

— 

— 

— 

— 

— 

Exercise
Price

Options
Outstanding

16.70     
$  
204.00     
$  
$  
820.00     
$ 1,052.00 - 8,100.00     

3,100     
5     
701     
3,015     
6,821     

Weighted
Average
Remaining
Contractual
Life

Weighted
Average
Exercise
Price

Number
Exercisable

Weighted
Average
Exercise
Price

7.44    $
6.56    $
6.20    $
4.03    $
5.81    $

F-23

16.70     
204.00     
820.00     
2,600.74     
1,241.59     

3,100    $
5    $
682    $
3,015    $
6,802    $

16.70 
204.00 
820.00 
2,600.74 
1,242.76 

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
   
   
   
 
   
   
      
  
   
      
  
   
   
      
  
   
      
  
   
 
     
       
       
     
 
 
   
 
     
       
       
     
 
 
   
 
 
   
 
   
 
 
     
 
   
   
 
     
 
   
 
 
   
 
 
     
 
   
   
     
 
   
 
 
   
 
   
   
   
 
   
 
   
   
   
   
   
 
 
 
 
   
 
      
 
There were no options granted or exercised during either of the years ended December 31, 2020 or 2019. For the years ended December 31, 2020 and
2019,  stock-based  compensation  expense  recognized  associated  with  stock  options  vesting  was  approximately  $58,000  and  $322,000,  respectively.  As
of December 31, 2020, there was approximately $4,000 of remaining unamortized stock-based compensation expense associated with unvested stock options,
which  will  be  expensed  over  a  weighted  average  remaining  service  period  of  approximately  0.2  years.  Because  of  the  Company’s  net  operating  losses,  the
Company did not realize any tax benefits from share-based payment arrangements for the years ended December 31, 2020 and 2019.

The Company’s RSUs generally vest annually over three years in equal increments. The Company measures the fair value of RSUs using the closing
stock price of a share of the Company’s common stock on the grant date and is recognized as expense on a straight-line basis over the vesting period of the
award. A summary of all RSU activity is presented below:

Awards outstanding at December 31, 2018

Awarded
Released
Forfeited

Awards outstanding at December 31, 2019

Awarded
Released
Forfeited

Awards outstanding at December 31, 2020

Weighted
Average
Grant Date
Fair Value

Weighted
Average
Remaining
Contractual
Term

17.34     
1.24     
17.95     
10.57     
4.09     
0.58     
4.57     
2.72     
3.84     

3.09 

1.81 

0.98 

Number of
Shares

294,066    $
764,151    $
(101,575)   $
(48,138)   $
908,504    $
47,500    $
(368,135)   $
(175,227)   $
412,642    $

As of December 31, 2020, there was approximately $1.1 million of remaining unamortized stock-based compensation expense associated with RSUs,
which will be expensed over a weighted average remaining service period of approximately 1.0 years. The 412,642 outstanding non-vested and expected to vest
RSUs  have  an  aggregate  fair  value  of  approximately  $0.2  million.  The  Company  used  the  closing  market  price  of  $0.44  per  share  at  December  31,  2020,  to
determine the aggregate fair value for the RSUs outstanding at that date. For the years ended December 31, 2020 and 2019, the fair value of RSUs vested was
approximately  $135,000  and  $116,000,  respectively.  For  the  years  ended  December  31,  2020  and  2019,  stock-based  compensation  expense  recognized
associated with RSUs vested was approximately $1.5 million and $1.8 million, respectively.

2018 Officer and Director Share Purchase Plan

On  August  22,  2018,  the  Board  of  Directors  of  the  Company  approved  the  adoption  of  an  Officer  and  Director  Share  Purchase  Plan  (“ODPP”),  which
allows executive officers and directors to purchase shares of our common stock at fair market value in lieu of salary or, in the case of directors, director fees.
Eligible  individuals  may  voluntarily  participate  in  the  ODPP  by  authorizing  payroll  deductions  or,  in  the  case  of  directors,  deductions  from  director  fees  for  the
purpose of purchasing common stock. The Board of Directors authorized 20,000 shares to be made available for purchase by officers and directors under the
ODPP. Effective on August 28, 2019 and March 10, 2020, the Board of Directors approved an additional 40,000 and 125,000 shares, respectively, to be made
available under the ODPP. Common stock issued under the ODPP during the years ended
December 31, 2020 and 2019 totaled 53,034 and 36,087 shares, respectively. As of December 31, 2020, there were 92,170 shares reserved for issuance under
the ODPP.

11. Stock-Based Compensation

Total noncash stock-based compensation expense relating to the Company’s stock options and RSUs recognized, before taxes, during the years ended

December 31, 2020 and 2019, is as follows (in thousands):

Cost of revenues
Research and development expenses
Selling, general and administrative expenses

Year Ended December 31,

2020

2019

132    $
469     
912     
1,513    $

169 
535 
1,387 
2,091 

  $

  $

F-24

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
   
   
 
   
   
  
   
  
   
  
   
   
  
   
  
   
  
   
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
   
 
 
12. Income Taxes

For  the  years  ended  December  31,  2020  and  2019,  the  Company’s  provision  for  income  taxes  consisted  of  zero  state  income  tax  expense.  A

reconciliation of the statutory U.S. federal rate to the Company’s effective tax rate is as follows (in thousands):

Tax at federal statutory rate
State taxes, net of federal benefit
Permanent differences
Change in valuation allowance
Research credits
Other

Provision for taxes

Year Ended December 31,
2019
2020

(3,991)   $
(760)    
56     
4,909     
(211)    
(3)    
—    $

(4,084)
(1,022)
97 
5,205 
(192)
(4)
— 

  $

  $

Significant components of the Company’s net deferred tax assets as of December 31, 2020 and 2019 consist of the following (in thousands):

Deferred tax assets:

Federal, state and foreign net operating losses
Research and other credits
Operating lease liability
Accruals and other
Total deferred tax assets
Less: Valuation allowance
Total net deferred tax assets

Deferred liabilities:
Fixed assets
Operating lease right of use asset

Total deferred tax liabilities

Net deferred tax assets (liabilities)

As of December 31,

2020

2019

79,253    $
4,766     
994     
2,305     
87,318     
(86,193)    
1,125     

(60)    
(1,065)    
(1,125)    
—    $

75,863 
4,361 
1,237 
2,847 
84,308 
(82,755)
1,553 

(198)
(1,355)
(1,553)
— 

  $

  $

The valuation allowance increased by $3.4 million and increased by $4.7 million during the years ended December 31, 2020 and 2019, respectively.

In connection with the adoption of ASC 842 in the quarter ended March 31, 2019, the Company recognized a deferred tax liability in the amount of $1.4
million related lease liabilities and a deferred tax asset in the amount of $1.2 million for the year ended December 31, 2019. The net effect of these adjustments
to the deferred tax asset and liability is offset with an adjustment to the valuation allowance.

As of December 31, 2020, the Company had approximately $318.2 million of federal and $179.0 million of state net operating loss carryforwards available
to offset future taxable income. If not utilized, the federal and state net operating loss carryforwards begin to expire in 2027 and 2024, respectively. Out of the
Federal net operating loss carryforwards, $60.7 million were generated post December 31, 2017 and have no expiration.

As of December 31, 2020, the Company also had approximately $3.8 million of research and development tax credit carryforwards available to reduce
future  taxable  income,  if  any,  for  both  federal  and  California  purposes.  The  federal  credit  carryforwards  expire  beginning  in  2027,  and  the  California  research
credits do not expire and may be carried forward indefinitely.

The Company's ability to utilize the net operating loss and tax credit carryforwards in the future may be subject to substantial restrictions in the event of
past  or  future  ownership  changes  as  defined  in  Section  382  of  the  Internal  Revenue  Code  and  similar  state  tax  laws.  In  the  event  the  Company  should
experience an ownership change, as defined, utilization of the Company's net operating loss carryforwards and tax credits could be limited.

F-25

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
   
 
   
   
   
   
   
 
 
 
 
 
 
 
   
 
     
       
 
   
   
   
   
   
   
     
       
 
   
   
   
 
 
 
 
 
 
The Company evaluates tax positions for recognition using a more-likely-than-not recognition threshold, and those tax positions eligible for recognition
are measured as the largest amount of tax benefit that is greater than 50% likely of being realized upon the effective settlement with a taxing authority that has full
knowledge of all relevant information.

A reconciliation of the beginning and ending amount of the gross recognized tax benefit is as follows (in thousands):

Balance at beginning of year

Increase based on the tax positions in the current year
Decrease for tax positions of prior year

Balance at end of year

As of December 31,

2020

2019

  $

  $

2,094    $
169     
44     
2,307    $

1,760 
177 
157 
2,094 

As of December 31, 2020, all unrecognized tax benefits are subject to a full valuation allowance and, if recognized, will not affect the Company’s tax rate.

The Company does not anticipate that the total amounts of unrecognized tax benefits will significantly increase or decrease in the next twelve months.

The Company's policy is to include interest and penalties related to unrecognized tax benefits within its provision for income taxes. Due to the Company's
net operating loss position, the Company has not recorded an accrual for interest or penalties related to uncertain tax positions for the years ended December
31, 2020 or 2019.

The  Coronavirus  Aid,  Relief,  and  Economic  Security  Act  (the  “CARES  Act”)  was  enacted  in  the  United  States  on  March  27,  2020.  The  CARES  Act
includes several U.S. income tax provisions related to, among other things, net operating loss carrybacks, alternative minimum tax credits, modifications to the
net  interest  deduction  limitations,  and  technical  amendments  regarding  the  income  tax  depreciation  of  qualified  improvement  property  placed  in  service  after
December 31, 2017. The CARES Act does not have a material impact on our financial results for the year ended December 31, 2020.

The Consolidated Appropriations Act, 2021 (the “Act”) was enacted in the United States on December 27, 2020.  The Act enhances and expands certain

provisions of the CARES Act, which among other things, allows deductions for expenses paid with proceeds from the PPP Loan. 

13. 401(k) Plan

The Company has a qualified retirement plan under section 401(k) of the Internal Revenue Code (“IRC”) under which participants may contribute up to
99% of their eligible compensation, subject to maximum deferral limits specified by the IRC. The Company may make a discretionary matching contribution to the
401(k) plan, and may make a discretionary employer contribution to each eligible employee each year. To date, the Company has made no contributions to the
401(k) plan.

14. Subsequent Events

Public Offering

On February 2, 2021, under the Shelf Registration Statement, we completed a bought deal offering of 10,000,000 shares of common stock at an offering
price of $1.44 per share. As a result, we received aggregate net proceeds of approximately $13.0 million after underwriting discounts, commissions, legal and
accounting fees, and other ancillary expenses.

CRG Debt Amendment

On  January  22,  2021,  the  Company  entered  into  Amendment  No.  5  to  the  Loan  with  CRG  (see  Footnote  7  Borrowings).  As  of  December  31,  2020,

principal, final facility fee and PIK payments under the Loan Agreement, which incorporates Amendment No. 5, are as follows (in thousands):

Year Ending December 31,
2021
2022
2023
2024
2025
Total
Less: Amount of PIK additions and facility fee to be accreted subsequent to December 31, 2020
Less: Amount representing debt financing costs

Borrowings, as of December 31, 2020

Incentive Payments

  $

  $

— 
— 
— 
9,045 
10,339 
19,384 
(8,322)
(418)
10,644 

On  March  9,  2021,  the  Company’s  Compensation  Committee  (the  “Committee”)  of  the  Board  of  Directors  determined  to  provide  certain  incentive
payments  (the  “Retention  Bonuses”)  to  certain  full-time  executive  officers  and  vice  presidents  of  the  Company  (the  “Bonus  Officers”),  based  on  certain
performance goals. The Retention Bonus consists of incentive payments in an amount equal to 100% of such Bonus Officer’s annual salary as of December 31,
2023, 50% of which will be paid if such Bonus Officer is in good standing in their service at the Company on December 31, 2023, and 50% to be paid if such
Bonus Officer is in good standing in their service at the Company on December 31, 2024 (each, a “Retention Bonus Payment”). The Retention Bonus Payment
may  be  increased  by  up  to  100%  if  the  Company’s  stock  price  exceeds  certain  stated  thresholds  and  is  payable  in  cash  and/or  equity  at  the  election  of  the
Committee. In addition, the Retention Bonus Payment may be accelerated in the event of a Change in Control of the Company (as defined in the Company’s
Amended and Restated 2015 Equity Incentive Plan).

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

F-26

 
 
 
 
 
 
 
 
 
   
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
   
   
   
   
   
   
   
 
 
 
Pursuant  to  the  requirements  of  Section  13  and  15(d)  of  the  Securities  Exchange  Act  of  1934,  the  registrant  has  duly  caused  this  Annual  Report  on

Form 10-K to be signed on its behalf by the undersigned thereunto duly authorized.

SIGNATURES

Date: March 11, 2021

Date: March 11, 2021

Avinger, Inc.
(Registrant)

/s/ Jeffrey M. Soinski
Jeffrey M. Soinski
Chief Executive Officer
(Principal Executive Officer)

/s/ Mark Weinswig
Mark Weinswig
Chief Financial Officer
(Principal Financial and Accounting Officer)

POWER OF ATTORNEY

KNOW  ALL  PERSONS  BY  THESE  PRESENTS,  that  each  person  whose  signature  appears  below  constitutes  and  appoints  Jeffrey  Soinski  and  Mark
Weinswig, jointly and severally, as his or her true and lawful attorneys-in-fact and agents, with full power of substitution and resubstitution, for him or her, and in
his or her name, place and stead, in any and all capacities, to sign any and all amendments to this Annual Report on Form 10-K, and to file the same, with all
exhibits thereto, and other documents in connection therewith, with the Securities and Exchange Commission, granting unto said attorneys-in-fact and agents full
power and authority to do and perform each and every act and thing requisite or necessary to be done in and about the premises hereby ratifying and confirming
all that said attorneys-in-fact and agents, or his substitute or substitutes, may lawfully do or cause to be done by virtue hereof.

Pursuant  to  the  requirements  of  the  Securities  Exchange  Act  of  1934,  as  amended,  this  Annual  Report  on  Form  10-K  has  been  signed  below  by  the

following persons on behalf of the registrant and in the capacities and on the dates indicated.

Signature

Title

/s/ Jeffrey M. Soinski
Jeffrey M. Soinski

/s/ Mark Weinswig
Mark Weinswig

/s/ James B. McElwee
James B. McElwee

/s/ James G. Cullen
James G. Cullen

/s/ Tamara Elias
Tamara Elias

Date

  March 11, 2021

  President and Chief Executive Officer (Principal Executive Officer);
  Director

  Chief Financial Officer (Principal Financial and Accounting Officer)

  March 11, 2021

  Director

  Director

  Director

86

  March 11, 2021

  March 11, 2021

  March 11, 2021

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consent of Independent Registered Public Accounting Firm

We consent to the incorporation by reference in the Registration Statements on Form S-1 (Nos. 333-222517, 333-227308, and 333-227689), Form S-3 (No. 333-
230124)  and  Form  S-8  (Nos.  333-201928,  333-209364,  333-216695,  333-227072,  333-233498,  and  333-237046)  pertaining  to  the  2015  Equity  Incentive  Plan
and  the  Officer  and  Director  Share  Purchase  Plan  of  Avinger,  Inc.,  of  our  report  dated  March  11,  2021,  relating  to  the  financial  statements  and  schedules  of
Avinger, Inc., appearing in this Annual Report (Form 10-K) for the year ended December 31, 2020.

Exhibit 23.1

/s/ Moss Adams LLP

San Francisco, California
March 11, 2021

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
CERTIFICATION OF THE CHIEF EXECUTIVE OFFICER
Pursuant to
Securities Exchange Act Rules 13a-14(a) and 15d-14(a),
As Adopted Pursuant to
Section 302 of the Sarbanes-Oxley Act of 2002

Exhibit 31.1

I, Jeffrey Soinski, hereby certify that:

1.     I have reviewed this Annual Report on Form 10-K of Avinger, Inc.;

2.     Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the

statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.          Based  on  my  knowledge,  the  financial  statements,  and  other  financial  information  included  in  this  Annual  Report  on  Form  10-K,  fairly  present  in  all

material respects the financial condition, results of operations, and cash flows of the registrant as of, and for, the periods presented in this report;

4.          The  registrant’s  other  certifying  officer  and  I  are  responsible  for  establishing  and  maintaining  disclosure  controls  and  procedures  (as  defined  in
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the
registrant and have:

a)     designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to
ensure  that  material  information  relating  to  the  registrant,  is  made  known  to  us  by  others  within  those  entities,  particularly  during  the  period  in  which  this
report is being prepared;

b)          designed  such  internal  control  over  financial  reporting,  or  caused  such  internal  control  over  financial  reporting  to  be  designed  under  our
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in
accordance with generally accepted accounting principles;

c)          evaluated  the  effectiveness  of  the  registrant’s  disclosure  controls  and  procedures  and  presented  in  this  report  our  conclusions  about  the
effectiveness of the disclosure controls and procedures, as of the end of the period covered by this Annual Report on Form 10-K based on such evaluation;
and

d)     disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during registrant’s most recent fiscal
quarter (the registrant’s fourth quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s
internal control over financial reporting;

5.          The  registrant’s  other  certifying  officer  and  I  have  disclosed,  based  on  our  most  recent  evaluation  of  internal  control  over  financial  reporting,  to  the

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)     all significant deficiencies and material weakness in the design or operation of internal control over financial reporting which are reasonably likely

to adversely affect the registrant’s ability to record, process, summarize, and report financial information; and

b)     any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control

over financial reporting.

Dated: March 11, 2021

/s/ Jeffrey M. Soinski
Jeffrey M. Soinski
Chief Executive Officer
(Principal Executive Officer)

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATION OF THE CHIEF FINANCIAL OFFICER
Pursuant to
Securities Exchange Act Rules 13a-14(a) and 15d-14(a),
As Adopted Pursuant to
Section 302 of the Sarbanes-Oxley Act of 2002

Exhibit 31.2

I, Mark Weinswig, hereby certify that:

1.     I have reviewed this Annual Report on Form 10-K of Avinger, Inc.;

2.     Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the

statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.          Based  on  my  knowledge,  the  financial  statements,  and  other  financial  information  included  in  this  report,  fairly  present  in  all  material  respects  the

financial condition, results of operations, and cash flows of the registrant as of, and for, the periods presented in this report;

4.          The  registrant’s  other  certifying  officer  and  I  are  responsible  for  establishing  and  maintaining  disclosure  controls  and  procedures  (as  defined  in
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the
registrant and have:

a)     designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to
ensure that material information relating to the registrant, is made known to us by others within those entities, particularly during the period in which this
report is being prepared;

b)          designed  such  internal  control  over  financial  reporting,  or  caused  such  internal  control  over  financial  reporting  to  be  designed  under  our
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes
in accordance with generally accepted accounting principles;

c)          evaluated  the  effectiveness  of  the  registrant’s  disclosure  controls  and  procedures  and  presented  in  this  report  our  conclusions  about  the

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report; and

d)     disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during registrant’s most recent fiscal
quarter  (the  registrant’s  fourth  fiscal  quarter  in  the  case  of  an  annual  report)  that  has  materially  affected,  or  is  reasonably  likely  to  materially  affect,  the
registrant’s internal control over financial reporting;

5.     The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the

registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a)     all significant deficiencies and material weakness in the design or operation of internal control over financial reporting which are reasonably likely

to adversely affect the registrant’s ability to record, process, summarize, and report financial information; and

b)     any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control

over financial reporting.

Dated: March 11, 2021

/s/ Mark Weinswig
Mark Weinswig
Chief Financial Officer
(Principal Financial and Accounting Officer)

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CERTIFICATIONS OF CHIEF EXECUTIVE OFFICER
AND CHIEF FINANCIAL OFFICER
PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF  2002

Exhibit 32.1

In connection with the Annual Report of Avinger, Inc. (the “Company”) on Form 10-K for the period ended December 31, 2020, as filed with the Securities and
Exchange Commission (the “Report”), Jeffrey Soinski, as Chief Executive Officer of the Company, and Mark Weinswig, Chief Financial Officer of the Company,
each hereby certifies, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 (18 U.S.C. Section 1350), to his knowledge:

1. The Report fully complies with the requirements of Section 13(a) or Section 15(d) of the Securities Exchange Act of 1934; and

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

IN WITNESS WHEREOF, the undersigned have set their hands hereto as of the 11th day of March, 2021.

/s/ Jeffrey M. Soinski
Jeffrey M. Soinski
Chief Executive Officer
(Principal Executive Officer)

/s/ Mark Weinswig

  Mark Weinswig
  Chief Financial Officer

(Principal Financial and Accounting Officer)

This  certification  accompanies  the  Form  10-K  to  which  it  relates,  is  not  deemed  filed  with  the  Securities  and  Exchange  Commission  and  is  not  to  be
incorporated by reference into any filing of the Registrant under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended
(whether made before or after the date of the Form 10-K), irrespective of any general incorporation language contained in such filing.

EDGAR Stream is a copyright of Issuer Direct Corporation, all rights reserved.