Document:

SECOND AMENDED AND RESTATED TIME NOTE

 Exhibit 10.21 
 SECOND AMENDED AND RESTATED TIME NOTE (SECURED) 
  

			
	$864,000.00	  	 Boston, Massachusetts

		  	                 As of May 20, 2006

 FOR VALUE RECEIVED, the undersigned LeMaitre Vascular, Inc. (the “Borrower”), hereby
promises to pay to the order of Brown Brothers Harriman & Co. (the “Bank”) the principal amount of Eight Hundred Sixty Four Thousand and 00/100 ($864,000.00) Dollars or such other principal amount as may be outstanding from time
to time in the aggregate hereunder (“Principal”), with interest, at the rate hereinafter set forth, on the daily balance of all unpaid Principal, from the date hereof until payment in full of all Principal and interest hereunder. Terms not
otherwise defined herein shall have the means prescribed to them in the Revolving Loan and Security Agreement and the Term Loan Agreement (each as defined below). 
 Interest on all unpaid Principal shall be due and payable in arrears, on the first eleventh day of each quarter, commencing on the first such date following any advance of principal hereunder, and on the date of
payment of this Note in full, at the fixed rate per annum (computed on the basis of a year of three hundred sixty (360) days for the actual number of days elapsed) as set forth in the Term Loan Agreement. 
 All outstanding Principal of this Note and all interest accrued thereon shall be due and payable in full in accordance with the terms of the Revolving
Loan and Security Agreement and the Term Loan Agreement. 
 Payments of Principal shall each be due and payable in accordance with the terms
of the Term Loan Agreement. Each Principal payment shall be in immediately available funds, at the principal office of the Bank (now located at 40 Water Street, Boston, Massachusetts 02109) or at such other address as the holder of this Note may
from time to time designate. 
 This Note is the note described in (i) a certain Third Amended and Restated Revolving Loan and Security
Agreement (the “Revolving Loan and Security Agreement”) to hereof, and, (ii) a certain Third Amended and Restated Term Loan Agreement (the “Term Loan Agreement”), each dated as of the date hereof and each executed by the
Borrower in favor of the Bank, and each as amended from time to time thereafter. This Note, is secured by any and all collateral at any time granted to the Bank to secure any obligations of the Borrower to the Bank, including, without limitation,
the Collateral described in such Revolving Loan and Security Agreement and the Term Loan Agreement and the trademarks described in an Assignment of Registered Trademarks dated May 24, 2002 and executed by the Borrower in favor of the Bank,
as amended by a letter amendment dated as of the date hereof by and between the Borrower and the Bank (the “Assignment”) (the Revolving Loan and Security Agreement, the Term Loan Agreement and the Assignment collectively, the
“Agreements”). 
 The Borrower may voluntarily prepay this Note in whole or in part at any time and from time to time as provided
in the Term Loan Agreement without penalty (except as set forth in the Term Loan Agreement), together with interest accrued on the amount prepaid through the date of payment. Any amounts prepaid hereunder may not be reborrowed. 
 The Borrower irrevocably authorizes the Bank to make or cause to be made, on a schedule attached to this Note or on the books of the Bank, at or
following the time of receipt by 

 
the Bank of any payment of Principal, an appropriate notation reflecting such transaction and the then aggregate unpaid balance of principal. Failure of the
Bank to make any such notation shall not, however, affect any obligation of any of the Borrowers hereunder or under the Agreements. The unpaid principal balance of this Note, as recorded by the Bank from time to time on such schedule or on such
books, shall constitute presumptive evidence of the Principal amount of loan outstanding hereunder. 
 Every maker, endorser and guarantor hereof or of the
indebtedness evidenced hereby (a) waives notice of and consents to any and all advances, settlements, compromises, favors and indulgences (including, without limitation, any extension or postponement of the time for payment), any and all
receipts, substitutions, additions, exchanges and releases of collateral, and any and all additions, substitutions and releases of any person primarily or secondarily liable, (b) waives presentment, demand, notice, protest and all other
demands, notices and suretyship defenses generally, in connection with the delivery, acceptance, performance, default or enforcement of or under this note, and (c) agrees to pay, to the extent permitted by law, all cost and expenses, including,
without limitation, reasonable attorneys’ fees, incurred or paid by the Bank in enforcing this Note and any collateral or security therefor on default, whether or not litigation is commenced. 
 This Note is referred to in, and is entitled to the benefits of, the Agreements. This Note may be accelerated upon the occurrence of a Default or an
Event of Default, all as provided in the Agreements. This Note amends and restates a First Amended, Restated and Combined Time Note (Secured) in the original principal amount of $2,160,000 dated April 11, 2003 (the “2003 Time Note”).
All amounts outstanding under the 2003 Time Note shall be deemed outstanding under this Note. 
 Executed, as an instrument under seal, as of
the day and year first above written. 
  

			
	LEMAITRE VASCULAR, INC.
		
	 By:
	 	/s/ Joseph P. Pellegrino
	 Name:
	 	Joseph P. Pellegrino, Jr.
	 Title:
	 	Executive Vice President – FinanceGUARANTY OF VASCUTECH ACQUISITION LLC

 Exhibit 10.22 
 GUARANTY 
 (Unlimited) 
 In consideration of Brown Brothers Harriman & Co. (the “Bank”) making extensions of credit or extending other financial or banking accommodations to Vascutech, Inc. (the “Obligor”), the
undersigned (the “Guarantor”) hereby guarantees full and punctual payment, performance and fulfillment to the Bank of all liabilities, obligations and undertakings of the Obligor to the Bank, whether direct or indirect, absolute or
contingent, due or to become due, now existing or hereafter arising or acquired, and whether consisting of obligations to pay money or to perform the Obligor’s obligations to the Bank under all present or future agreements of the Obligor in
favor of the Bank (the “Obligations”). This agreement shall operate as a continuing, unconditional and absolute guaranty (this “Guaranty”) of the due and punctual payment of the Obligations, and not of their collectibility only.
If the Obligor defaults in the payment or performance of the Obligations, the Bank shall provide notice of such default. But, such notice shall not affect any of the Bank’s rights under this Guaranty nor shall such notice be required as a
condition precedent to the obligations of the Guarantor under this Guaranty which shall become immediately due and payable to the Bank upon the Obligor’s default. The Guarantor waives any right which the Guarantor may have to require the Bank
first to proceed against the Obligor or against any other guarantor or any other person. The Guarantor also waives any right that the Guarantor may have to require the Bank to realize on any security held by the Bank before proceeding against the
Guarantor for the enforcement of this Guaranty. The Guarantor agrees not to assert any right arising from payment or performance under this Guaranty, whether by set-off or counterclaim, or claim of indemnity or reimbursement, or otherwise, until the
Guarantor’s liability hereunder has been discharged in full and all Obligations have been fulfilled. 
 The liability
of the Guarantor under this Guaranty shall be limited to the sum of $2,600,000. 
 The Guarantor agrees, as the principal obligor and not as a guarantor
only, to pay to the Bank, on demand, all costs and expenses paid or incurred by the Bank (including reasonable attorneys’ fees) in connection with the Obligations, this Guaranty and the enforcement thereof. 
 The Guarantor waives presentment, demand, protest, notice of acceptance, notice of the Obligations incurred and all other notices of any kind and all defenses which may
be available to the Guarantor. The Guarantor agrees to the provisions of any instrument, security or other writing evidencing or securing any of the Obligations and agrees that the obligations of the Guarantor hereunder shall not be released or
discharged, in whole or in part, by (i) any renewals, extensions or postponements of the time of payment of any of the Obligations or any other forbearance or indulgence with respect thereto; (ii) any rescissions, waivers, amendments or
modifications of any of the terms of any agreement evidencing, securing or otherwise executed in connection with the Obligations; or (iii) the substitution or release of any security for the Obligations or of any other person primarily or
secondarily liable on any of the Obligations, whether or not notice thereof shall be given to the Guarantor. The enforcement of this Guaranty shall not be affected by the delay, neglect or failure of the Bank to take any action with respect to

 
any security, right, obligation, endorsement, guaranty or other means of collecting the Obligations which it may at any time hold, including perfection or
enforcement thereof, or by any change with respect to the Obligor in the form or manner of doing business. The Guarantor agrees that the Guarantor shall be and remain bound upon this Guaranty irrespective of any action, delay or omission by the Bank
in dealing with the Obligor, any of the Obligations, any collateral therefor, or any person at any time liable with respect to the Obligations. 
 If for any
reason the Obligor has no legal existence or is under no legal obligation to discharge any of the Obligations, or if any of the Obligations shall have become irrecoverable from the Obligor by operation of law or for any other reason, or if any
security or other guaranty shall be found invalid, the Guarantor shall nonetheless be and remain bound upon this Guaranty. 
 Any deposits or other sums at
any time credited by or due from the Bank to the Guarantor, and any securities or other property of the Guarantor at any time held by the Bank may at all times be held and treated as security for all obligations of the Guarantor under this Guaranty.
Regardless of the adequacy of the security, the Bank may apply or set off such deposits or other sums against such obligations at any time, without notice to the Guarantor. 
 This Guaranty shall remain in full force and effect until receipt by the Bank of written notice of the revocation of this Guaranty at its head office at 40 Water Street, Boston, Massachusetts 02109, and such notice is
acknowledged by an officer of the Bank. Such notice shall not affect any Obligations incurred prior to receipt of such notice or Obligations incurred pursuant to any contract or commitment in existence prior to receipt of such notice, and all
checks, drafts, notes, instruments and writings made by or for the account of the Obligor and drawn on the Bank or any of its agents purporting to be dated on or before the date of receipt of such notice, although presented to and paid or accepted
by the Bank after that date, shall form part of the Obligations. This Guaranty shall continue to be effective or be reinstated, notwithstanding any termination, if at any time any payment made or value received with respect to any of the Obligations
is rescinded or must otherwise be returned by the Bank due to the insolvency, bankruptcy or reorganization of the Obligor, or otherwise, all as though such payment had not been made or value received. 
 This Guaranty shall be binding upon and inure to the benefit of the Guarantor and the Bank and their respective successors and assigns. No provision of this Guaranty may
be amended or waived except in writing signed by the Bank. The invalidity or unenforceability of any one or more phrases, clauses or sections of this Guaranty shall not affect the validity or enforceability of the remaining portions of it.

 This Guaranty is intended to take effect as a sealed instrument and shall be construed in accordance with and governed by the laws (other than the
conflict of laws rules) of the Commonwealth of Massachusetts and shall be effective as of March 29, 2001. 
  

					
	Witness:	 	Guarantor:
		
		 	VASCUTECH ACQUISITION LLC
			
	 /s/ John Markella
	 	 By:
	 	 /s/ David B. Roberts

		 		 	 Name: David B. Roberts
 Title: Assistant Secretary

  

 2 

 As of April 11, 2003 
 Vascutech Acquisition LLC 
 26 Ray Avenue 
 Burlington, MA 01803 
 Ladies and Gentlemen: 
 Reference is made
to a Guaranty (Unlimited) effective March 29, 2001 executed by Vascutech Acquisition LLC (the “Guarantor”) in favor of Brown Brothers Harriman & Co. (“BBH”) in support of the obligations of LeMaitre Vascular, Inc.
(the “Borrower”) to BBH pursuant to revolving line of credit in the amount not to exceed $1,500,000 in the aggregate (the “Line of Credit”), a term loan in the original principal amount of $1,100,000 (the “$1,l00M Term
Loan”), and a term loan in the original amount of $956,000 (the “$956,000 Term Loan”), each made available by BBH to Borrower pursuant to a First Amended and Restated Revolving Loan and Security Agreement (the “Revolving Loan
Agreement”) and a First Amended and Restated Term Loan Agreement (the “Term Loan Agreement’), respectively, each executed by BBH and the Borrower and dated as of November 15, 2001 and as each is further amended by separate letter
agreements dated as of February 7, 2002, as of May 15, 2002, and as of July 16, 2002, each by and between the Borrower and BBH. Obligations of the Guarantor under the Guaranty are secured by certain Collateral as defined in a Security
Agreement dated as of May 29, 2001 executed by the Guarantor in favor of BBH, as amended by separate letter agreements dated as of February 7, 2002 and as of May 15, 2002, each by and between the Guarantor and BBH (the “Security
Agreement”). 
 The Borrower has requested and BBH has agreed to (i) combine the outstanding balance under the $1,100M Term Loan together with such
additional sums extended to the Borrower by BBH not to exceed the amount of $2,160,000 in the aggregate as a new term loan, (ii) extend a new term loan in the original principal amount of $1,500,000, (iii) renew and extend the availability
of the Line of Credit, and (iv) amend and restate each of the Revolving Loan Agreement and the Term Loan Agreement (collectively as amended and restated, the “Second Amended and Restated Agreements”), provided that the Guarantor
agrees to certain modifications to the Guaranty and the Security Agreement. Now therefore, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Guarantor and BBH agree to amend the Guaranty and the
Security Agreement as follows: 
  

	I.	Amendment to the Guaranty 

 The second paragraph on
page 1 of the Guaranty is hereby amended to read as follows: “The liability of the Guarantor under this Guaranty shall be limited to the sum of $4,122,000.” 
  

 3 

	II.	Amendment to the Security Agreement 

 1. The second paragraph on
page 1 of the Security Agreement is hereby deleted in its entirety, and the following is substituted therefor: 
 “Whereas the Guarantor
has agreed to guaranty the obligations of Vascutech, Inc. (the “Borrower”) to the Secured Party up to the amount of $4,122,000 in the aggregate under (i) a revolving line of credit (including any irrevocable letters of credit issued
from time to time thereunder by the Secured Party for the benefit of the Borrower) not to exceed $1,500,000 in the aggregate, and (ii) three term loan facilities, one in the original principal amount of $2,160,000 and the second in the original
principal amount of $1,500,000, and the third in the original principal amount of $956,000, all pursuant to a Guaranty (Unlimited) effective as of March 29, 2001 executed by the Guarantor in favor of the Secured Party, as amended by a letter
agreement dated as of April 11, 2003 by and between the Guarantor and the Secured Party (the “Guaranty”);” 
 2. The first and third
sentences of Section 3.4 and the first sentence of Section 3.6 of the Security Agreement are each hereby amended by inserting “Other than leased equipment,” at the beginning thereof. 
 3. The final sentence of Section 3.10 of the Security Agreement is hereby deleted in its entirety and the following is substituted therefor: 
 “Any proceeds of Accounts or Inventory constituting Collateral received by the Guarantor, whether in the form of cash, checks, notes or other
instruments, shall be held in trust for the Secured Party and upon the occurrence of an Event of Default, the Guarantor shall deliver said proceeds daily to the Secured Party, without commingling, in the identical form received (properly endorsed or
assigned where required to enable the Secured Party to collect same).” 
  

	III.	Miscellaneous 

 1. All terms and provisions of the Guaranty and the
Security Agreement, each as amended hereby, are hereby ratified and affirmed as of the date hereof and are hereby extended to give effect to the terms hereof. 
 2. By signing below where indicated, the Guarantor i) ratifies and affirms each of the representations and warranties set forth in the Guaranty and the Security Agreement and confirms that each remains true and accurate as of the date
hereof, and ii) ratifies the terms and conditions of the Guaranty and the Security Agreement, each as amended. 
 3. This letter, the Second Amended and
Restated Agreements, the Guaranty, the Security Agreement, the Subordination Agreement and the other notes, agreements, documents and certificates referred to herein or therein constitute the entire understanding of the parties with respect to the
subject matter hereof and thereof and supersede all prior or current understandings and agreements, whether written or oral. This letter may be executed in any number of counterparts, which together shall constitute one instrument, and shall bind
and inure to the 

  

 4 

 
benefit of the parties and their respective successors and assigns. This letter shall be construed in accordance with the laws (other than conflict of laws
rules) of the Commonwealth of Massachusetts and when executed and delivered will be considered an agreement under seal. 
 Please execute the enclosed copy of this letter and return the same to the undersigned. 
  

			
	Yours very truly,
	
	 BROWN BROTHERS HARRIMAN & CO.

		
	By:	 	 /s/ Joseph E. Hall

	 Name: Joseph E. Hall
 Title: Managing Director

  

			
	Acknowledged and agreed:
	
	VASCUTECH ACQUISITION LLC
		
	By:	 	 /s/ David Roberts

	 Name: David Roberts
 Title: CFO
  
 Date: April 11, 2003

  

 5 

 As of February 5, 2004 
 Vascutech Acquisition LLC 
 63 Second Avenue 
 Burlington, MA 01803 
 Ladies and Gentlemen: 
 Reference is made
to a Guaranty (Unlimited) effective March 29, 2001 executed by Vascutech Acquisition LLC (the “Guarantor”) in favor of Brown Brothers Harriman & Co. (“BBH”) in support of the obligations of LeMaitre Vascular, Inc.
(the “Borrower”) to BBH pursuant to, among other obligations, a revolving line of credit in the amount not to exceed $1,500,000 in the aggregate (the “Line of Credit”) made available by BBH to Borrower pursuant to a First Amended
and Restated Revolving Loan and Security Agreement executed by BBH and the Borrower and dated as of April 11, 2003 (the “Loan Agreement”). Obligations of the Guarantor under the Guaranty are secured by certain Collateral as defined in
a Security Agreement dated as of May 29, 2001 executed by the Guarantor in favor of BBH, as amended by separate letter agreements dated as of February 7, 2002, as of May 15, 2002, and as of April 11, 2003, each by and between the
Guarantor and BBH (the “Security Agreement”). 
 The Borrower has requested and BBH has agreed to temporarily increase the Line of Credit from the
principal amount of $1,500,000 to the principal amount of $2,500,000 in the aggregate, provided that the Guarantor agrees to certain modifications to the Guaranty and the Security Agreement. Now therefore, for good and valuable consideration, the
receipt and sufficiency of which is hereby acknowledged, the Guarantor and BBH agree to amend the Guaranty and the Security Agreement as follows: 
  

	I.	Amendment to the Guaranty 

 The second paragraph on
page 1 of the Guaranty is hereby amended to read as follows: “The liability of the Guarantor under this Guaranty shall be limited to the sum of $4,660,000.” 
  

	II.	Amendment to the Security Agreement 

 The second
paragraph on page 1 of the Security Agreement is hereby deleted in its entirety, and the following is substituted therefor: 
 “Whereas
the Guarantor has agreed to guaranty the obligations of Vascutech, Inc. (the “Borrower”) to the Secured Party up to the amount of $4,660,000 in the aggregate under (i) a revolving line of credit (including any irrevocable letters of
credit issued from time to time thereunder by the Secured Party for the benefit of the Borrower) not to exceed $2,500,000 in the aggregate, and (ii) a term loan facility in the original principal amount of $2,160,000, each pursuant to a
Guaranty (Unlimited) effective as of March 29, 2001 executed by the Guarantor in favor of the Secured Party, as amended by separate letter agreements dated as of April 11, 2003 and as of February 5, 2004, each by and between the
Guarantor and the Secured Party (the “Guaranty”);”. 
  

 6 

	III.	Miscellaneous 

 1. All terms and provisions of the Guaranty and the
Security Agreement, each as amended hereby, are hereby ratified and affirmed as of the date hereof and are hereby extended to give effect to the terms hereof. 
 2. By signing below where indicated, the Guarantor ratifies and affirms each of the representations and warranties set forth in the Guaranty and the Security Agreement and confirms that each remains true and accurate as of the date hereof.

 3. This letter, the Loan Agreement, the Guaranty, the Security Agreement, the Subordination Agreement and the other notes, agreements, documents and
certificates referred to herein or therein constitute the entire understanding of the parties with respect to the subject matter hereof and thereof and supersede all prior or current understandings and agreements, whether written or oral. This
letter may be executed in any number of counterparts, which together shall constitute one instrument, and shall bind and inure to the benefit of the parties and their respective successors and assigns. This letter shall be construed in accordance
with the laws (other than conflict of laws rules) of the Commonwealth of Massachusetts and when executed and delivered will be considered an agreement under seal. 
 Please execute the enclosed copy of this letter and return the same to the undersigned. 
  

			
	 Yours very truly,
  
 BROWN BROTHERS HARRIMAN & CO.

		
	By:	 	 /s/ Joseph E. Hall

	 Name: Joseph E. Hall
 Title: Managing Director

  

			
	 Acknowledged and agreed:
  
 VASCUTECH ACQUISITION LLC

		
	By:	 	 /s/ David Roberts

	 Name: David Roberts
 Title: CFO
  
 Date: February 5, 2004

  

 7 

 As of August 5, 2004 
 Vascutech Acquisition LLC 
 63 Second Avenue 
 Burlington, MA 01803 
 Ladies and Gentlemen: 
 Reference is made
to a Guaranty (Unlimited) effective March 29, 2001 executed by Vascutech Acquisition LLC (the “Guarantor”) in favor of Brown Brothers Harriman & Co. (“BBH”), as amended by a letter agreement dated as of
February 5, 2004 by and between the Guarantor and BBH (the “Guaranty”), in support of the obligations of LeMaitre Vascular, Inc. (the “Borrower”) to BBH pursuant to, among other obligations, a revolving line of credit in the
amount not to exceed $2,500,000 in the aggregate (the “Line of Credit”) made available by BBH to Borrower pursuant to a First Amended and Restated Revolving Loan and Security Agreement executed by BBH and the Borrower and dated as of
April 11, 2003, as amended by a letter agreement dated as of February 5, 2004 by and between the Borrower and BBH (the “Loan Agreement”). Obligations of the Guarantor under the Guaranty are secured by certain Collateral as
defined in a Security Agreement dated as of May 29, 2001 executed by the Guarantor in favor of BBH, as amended by separate letter agreements dated as of February 7, 2002, as of May 15, 2002, as of April 11, 2003, and as of
February 5, 2004, each by and between the Guarantor and BBH (the “Security Agreement”). 
 The Borrower has requested and BBH has agreed to
decrease the Line of Credit from the principal amount of $2,500,000 to the principal amount of $2,250,000 in the aggregate, provided that the Guarantor agrees to certain modifications to the Guaranty and the Security Agreement. Now therefore, for
good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Guarantor and BBH agree to amend the Guaranty and the Security Agreement as follows: 
  

	I.	Amendment to the Guaranty 

 The second paragraph on
page 1 of the Guaranty is hereby amended to read as follows: “The liability of the Guarantor under this Guaranty shall be limited to the sum of $4,410,000.” 
  

	II.	Amendment to the Security Agreement 

 The second
paragraph on page 1 of the Security Agreement is hereby deleted in its entirety, and the following is substituted therefor: 
 “Whereas
the Guarantor has agreed to guaranty the obligations of Vascutech, Inc. (the “Borrower”) to the Secured Party up to the amount of $4,410,000 in the aggregate under (i) a revolving line of credit (including any irrevocable letters of
credit issued from time to time thereunder by the Secured Party for the benefit of the Borrower) not to exceed $2,250,000 in the aggregate, and (ii) a term loan facility in the original principal amount of $2,160,000, each pursuant to a
Guaranty (Unlimited) effective as of March 29, 2001 
  

 8 

 
executed by the Guarantor in favor of the Secured Party, as amended by separate letter agreements dated as of April 11, 2003, as of February 5,
2004, and as of August 5, 2004, each by and between the Guarantor and the Secured Party (the “Guaranty”);”. 
  

	III.	Miscellaneous 

 1. All terms and provisions of the Guaranty and the
Security Agreement, each as amended hereby, are hereby ratified and affirmed as of the date hereof and are hereby extended to give effect to the terms hereof. 
 2. By signing below where indicated, the Guarantor ratifies and affirms each of the representations and warranties set forth in the Guaranty and the Security Agreement and confirms that each remains true and accurate as of the date hereof.

 3. This letter, the Loan Agreement, the Guaranty, the Security Agreement and the other notes, agreements, documents and certificates referred to herein or
therein constitute the entire understanding of the parties with respect to the subject matter hereof and thereof and supersede all prior or current understandings and agreements, whether written or oral. This letter may be executed in any number of
counterparts, which together shall constitute one instrument, and shall bind and inure to the benefit of the parties and their respective successors and assigns. This letter shall be construed in accordance with the laws (other than conflict of laws
rules) of the Commonwealth of Massachusetts and when executed and delivered will be considered an agreement under seal. 
 Please execute the enclosed copy of this letter and return the same to the undersigned. 
  

			
	Yours very truly,
	
	 BROWN BROTHERS HARRIMAN & CO.

		
	By:	 	 /s/ Joseph E. Hall

	 Name: Joseph E. Hall
 Title: Managing Director

  

			
	 Acknowledged and agreed:

	
	 VASCUTECH ACQUISITION LLC

		
	By:	 	 /s/ David Roberts

	 Name: David Roberts
 Title: CFO
  
 Date: October 1, 2004

  

 9 

 As of February 2, 2005 
 Vascutech Acquisition LLC 
 63 Second Avenue 
 Burlington, MA 01803 
 Ladies and Gentlemen: 
 Reference is made
to a Guaranty (Unlimited) effective March 29, 2001 executed by Vascutech Acquisition LLC (the “Guarantor”) in favor of Brown Brothers Harriman & Co. (“BBH”), as amended by separate letter agreements dated as of
February 5, 2004 and as of August 5, 2004, each by and between the Guarantor and BBH (the “Guaranty”), in support of the obligations of LeMaitre Vascular, Inc. (the “Borrower”) to BBH pursuant to, among other
obligations, a revolving line of credit in the amount not to exceed $2,250,000 in the aggregate (the “Line of Credit”) made available by BBH to Borrower pursuant to a First Amended and Restated Revolving Loan and Security Agreement
executed by BBH and the Borrower and dated as of April 11, 2003, as amended by separate letter agreements dated as of February 5, 2004 and as of August 5, 2004, each by and between the Borrower and BBH (the “Loan
Agreement”). Obligations of the Guarantor under the Guaranty are secured by certain Collateral as defined in a Security Agreement dated as of May 29, 2001 executed by the Guarantor in favor of BBH, as amended by separate letter agreements
dated as of February 7, 2002, as of May 15, 2002, as of April 11, 2003, as of February 5, 2004, and as of August 5, 2004, each by and between the Guarantor and BBH (the “Security Agreement”). 
 The Borrower has requested and BBH has agreed to temporarily increase the Line of Credit from the principal amount of $2,250,000 to the principal amount of $3,500,000 in
the aggregate, provided that the Guarantor agrees to certain modifications to the Guaranty and the Security Agreement. Now therefore, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Guarantor and
BBH agree to amend the Guaranty and the Security Agreement as follows: 
  

	I.	Amendment to the Guaranty 

 The second paragraph on
page 1 of the Guaranty is hereby amended to read as follows: “The liability of the Guarantor under this Guaranty shall be limited to the sum of $5,660,000.” 
  

	II.	Amendment to the Security Agreement 

 The second
paragraph on page 1 of the Security Agreement is hereby deleted in its entirety, and the following is substituted therefor: 
 “Whereas
the Guarantor has agreed to guaranty the obligations of Vascutech, Inc. (the “Borrower”) to the Secured Party up to the amount of 5,660,000 in the aggregate under (i) a revolving line of credit (including any irrevocable letters of
credit issued from time to time thereunder by the Secured Party for the benefit of the Borrower) not to exceed $3,500,000 in the aggregate, and (ii) a term loan facility in the original principal amount 

  

 10 

 
of $2,160,000, each pursuant to a Guaranty (Unlimited) effective as of March 29, 2001 executed by the Guarantor in favor of the Secured Party, as
amended by separate letter agreements dated as of April 11, 2003, as of February 5, 2004, and as of August 5, 2004, each by and between the Guarantor and the Secured Party (the “Guaranty”);”. 
  

	III.	Miscellaneous 

 1. All terms and provisions of the Guaranty and the
Security Agreement, each as amended hereby, are hereby ratified and affirmed as of the date hereof and are hereby extended to give effect to the terms hereof. 
 2. By signing below where indicated, the Guarantor ratifies and affirms each of the representations and warranties set forth in the Guaranty and the Security Agreement and confirms that each remains true and accurate as of the date hereof.

 3. This letter, the Loan Agreement, the Guaranty, the Security Agreement and the other notes, agreements, documents and certificates referred to herein or
therein constitute the entire understanding of the parties with respect to the subject matter hereof and thereof and supersede all prior or current understandings and agreements, whether written or oral. This letter may be executed in any number of
counterparts, which together shall constitute one instrument, and shall bind and inure to the benefit of the parties and their respective successors and assigns. This letter shall be construed in accordance with the laws (other than conflict of laws
rules) of the Commonwealth of Massachusetts and when executed and delivered will be considered an agreement under seal. 
 Please execute the enclosed copy
of this letter and return the same to the undersigned. 
  

			
	Yours very truly,
	
	 BROWN BROTHERS HARRIMAN & CO.

		
	By:	 	 /s/ Joseph E. Hall

	 Name: Joseph E. Hall
 Title: Managing Director

  

			
	Acknowledged and agreed:
	
	 VASCUTECH ACQUISITION LLC

		
	By:	 	 /s/ David Roberts

	 Name: David Roberts
 Title: CFO
  
 Date: February 2, 2005

  

 11 

 As of May 20, 2006 
 Vascutech Acquisition LLC 
 63 Second Avenue 
 Burlington, MA 01803 
 Ladies and Gentlemen: 
 Reference is made
to a Guaranty (Unlimited) effective March 29, 2001 executed by Vascutech Acquisition LLC (the “Guarantor”) in favor of Brown Brothers Harriman & Co. (“BBH”), as amended to date (the “Guaranty”), in support
of the obligations of LeMaitre Vascular, Inc. (the “Borrower”) to BBH pursuant to, among other obligations, (i) a revolving line of credit in the amount not to exceed $5,500,000 in the aggregate (the “Line of Credit”) made
available by BBH to Borrower pursuant to a Third Amended and Restated Revolving Loan and Security Agreement (the “Loan Agreement”) and (ii) a term loan in the original principal amount of $2,160,000 with a current outstanding
principal balance of $864,000 (the “Term Loan”) extended by BBH to the Borrower pursuant to a Third Amended and Restated Term Loan Agreement, each dated as of May 20, 2006 and each executed by the Borrower and BBH. Obligations of the
Guarantor under the Guaranty are secured by certain Collateral as defined in a Security Agreement dated as of May 29, 2001 executed by the Guarantor in favor of BBH, as amended to date (the “Security Agreement”). 
 The Borrower has requested and BBH has agreed to modify the terms of the Line of Credit and the Term Loan, provided that the Guarantor agrees to certain modifications to
the Guaranty and the Security Agreement. Now therefore, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Guarantor and BBH agree to amend the Guaranty and the Security Agreement as follows:

  

	I.	Amendment to the Guaranty 

 The second paragraph on
page 1 of the Guaranty is hereby amended to read as follows: “The liability of the Guarantor under this Guaranty shall be limited to the sum of $6,364,000.” 
  

	II.	Amendment to the Security Agreement 

 The second
paragraph on page 1 of the Security Agreement is hereby deleted in its entirety, and the following is substituted therefor: 
 “Whereas
the Guarantor has agreed to guaranty the obligations of Vascutech, Inc. (the “Borrower”) to the Secured Party up to the amount of $6,814,000 in the aggregate under (i) a revolving line of credit (including any irrevocable letters of
credit issued from time to time thereunder by the Secured Party for the benefit of the Borrower) not to exceed $5,500,000 in the aggregate, and (ii) a term loan facility in the original principal amount 

  

 12 

 
of $2,160,000 and with a current principal balance outstanding in the amount of $864,0000, each pursuant to a Guaranty (Unlimited) effective as of
March 29, 2001 executed by the Guarantor in favor of the Secured Party, as amended from time to time hereafter (the “Guaranty”);”. 
  

	III.	Miscellaneous 

 1. All terms and provisions of the Guaranty and the
Security Agreement, each as amended hereby, are hereby ratified and affirmed as of the date hereof and are hereby extended to give effect to the terms hereof. 
 2. By signing below where indicated, the Guarantor ratifies and affirms each of the representations and warranties set forth in the Guaranty and the Security Agreement and confirms that each remains true and accurate as of the date hereof.

 3. This letter, the Loan Agreement, the Guaranty, the Security Agreement and the other notes, agreements, documents and certificates referred to herein or
therein constitute the entire understanding of the parties with respect to the subject matter hereof and thereof and supersede all prior or current understandings and agreements, whether written or oral. This letter may be executed in any number of
counterparts, which together shall constitute one instrument, and shall bind and inure to the benefit of the parties and their respective successors and assigns. This letter shall be construed in accordance with the laws (other than conflict of laws
rules) of the Commonwealth of Massachusetts and when executed and delivered will be considered an agreement under seal. 
 Please execute the enclosed copy of this letter and return the same to the undersigned. 
  

			
	Yours very truly,
	
	 BROWN BROTHERS HARRIMAN & CO.

		
	By:	 	 /s/ J. Edward Hall

	 Name: J. Edward Hall
 Title: Managing Director

	
	 Acknowledged and agreed:
  
 VASCUTECH ACQUISITION LLC

	
	 By LeMaitre Vascular, Inc.,

	 its sole member

		
	 By:
	 	 /s/ Joseph P. Pellegrino, Jr.

	 Name: Joseph P. Pellegrino, Jr.
 Title: Executive Vice President - Finance
  
 Date: May 18, 2006

  

 13

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