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Acquisitions Pro forma combined financial information (Details) - Vascular Solutions and NeoTract Acquisitions - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Business Acquisition [Line Items]    
Net revenue $ 2,255,696 $ 2,084,439
Net income $ 119,934 $ 106,512
Earnings per share, basic (in dollars per share) $ 2.66 $ 2.46
Earnings per share, diluted (in dollars per share) $ 2.57 $ 2.24
Weighted average basic shares outstanding, pro forma (in shares) 45,004 43,325
Pro forma weighted average shares outstanding, diluted (in shares) 46,664 47,646