K Number
K031852
Date Cleared
2003-08-20

(65 days)

Product Code
Regulation Number
882.5950
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Sapphire Detachable Coils are intended for the endovascular embolization of intracranial aneurysms that - because of their morphology, their location, or the patient's general medical condition - are considered by the treating neurosurgical team to be a) very high risk for management by traditional operative techniques, or b) be inoperable.

The intended uses of the Sapphire fiber coils are narrowed relative to the predicate device GDC, but still fall within the 510(k) cleared intended use.

Sapphire Detachable Fibered Coil - The Sapphire fibered coil is intended for embolization of neurovascular abnormalities such as arteriovenous malformations (AVMs) and arteriovenous fistulae. The Fibered Sapphire is also intended for arterial and venous embolizations in the peripheral vasculature.

Device Description

The Sapphire Detachable Coil (SDC) is manufactured from a platinum alloy wire which is first wound into primary coil and then formed into a secondary helical shape. The coil is welded to a positioning wire, which consist of ground stainless steel core wire with a stainless steel coil laser welded at the distal end and a Teflon outer jacket. The coil is detached by the battery operated power supply (Sapphire Detachment System, SDS), which dissolves a small detachment element between the emboliozation coil and the positioning wire. The fibered coil is manufactured with nylon fibers secured into the primary coil. The fibered coils are available in two shapes (Helix and Cyclone) and different sizes.

AI/ML Overview

The Sapphire Detachable Fibered Coil System demonstrates its acceptance criteria and performance through a series of bench, animal, and physician evaluation tests. The device's substantial equivalence to the predicate device, Target GDC fibered coils, is asserted based on similar intended use, operating principles, basic design, and sterilization processes.

1. Table of Acceptance Criteria and Reported Device Performance

Test CategorySpecific TestAcceptance Criteria & Reported Performance
Bench TestingCoil Strength (Coil Deformation and Softness)Meet established acceptance criteria
Ease of DeliveryMeet established acceptance criteria
Reliability After Fatigue & Premature DetachmentMeet established acceptance criteria
Tensile Strength of Coil & Detachment ZoneMeet established acceptance criteria
Tensile Strength of Delivery WireMeet established acceptance criteria
Delivery Wire FlexibilityMeet established acceptance criteria
Detachment TimeMeet established acceptance criteria
RadiopacityMeet established acceptance criteria
Particulate Generation of Detachment ZoneMeet established acceptance criteria
Aging and Shelf Life (3 year)Meet established acceptance criteria
Fiber Pull OutMeet established acceptance criteria
Fiber EnduranceMeet established acceptance criteria
Packaging validation after 3-year accelerated agingMeet established acceptance criteria
Animal TestingCoil Per Aneurysm (Avg./S.D.)Comparable to the Predicate Device
Detachment Time (seconds)Comparable to the Predicate Device
Coil Detachment Reliability (detachment attempts/coil)The Sapphire demonstrated higher reliability compared to the Predicate Device
Post Embolization Angiographic AssessmentComparable to the Predicate Device
Angiographic Assessment One-Month Follow-UpComparable to the Predicate Device
Angiographic Assessment Three-Month Follow-UpComparable to the Predicate Device
Physician Device EvaluationEase of Coil PreparationComparable to acceptance criteria
Ability to move coil within CatheterComparable to acceptance criteria
AccessAcceptance Criteria
Ability to Place catheter tip in desired locationComparable to acceptance criteria
Trackability, Friction of coil through catheterComparable to acceptance criteria
Coil VisualizationAcceptance Criteria
Fluoroscopic visibility of CoilComparable to acceptance criteria
Fluoroscopic visibility of Detachment MarkersComparable to acceptance criteria
Coil Delivery ProcedureAcceptance Criteria
Ability to Position Coil in SacComparable to acceptance criteria
Detachment TimeComparable to acceptance criteria
Ability to Pack Aneurysm SacComparable to acceptance criteria
Ability to RepositionComparable to acceptance criteria
Ease of use of the SDS Detachment SystemComparable to acceptance criteria
Coil Positional Stability/Aneurysm OcclusionComparable to acceptance criteria
Overall (Ease of Use)Comparable to acceptance criteria
Overall (Overall performance)Comparable to acceptance criteria
MRI CompatibilityMRI CompatibilityCompatible with 1.5 Tesla

2. Sample size used for the Test Set and Data Provenance

The provided document does not explicitly state the sample size for the test set used in the animal testing or physician device evaluation. Similarly, the data provenance (e.g., country of origin, retrospective or prospective nature) for these tests is not specified. The bench testing would likely be performed in a laboratory setting, not involving human or animal subjects in the same way.

3. Number of Experts and their Qualifications for Ground Truth

The document does not specify the number of experts used or their qualifications for establishing ground truth, particularly for the animal testing or physician device evaluation. However, the "Physician Device Evaluation" implies the involvement of medical professionals in assessing the device's practical performance.

4. Adjudication Method

The document does not describe any specific adjudication method (e.g., 2+1, 3+1, none) for the test set.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No Multi-Reader Multi-Case (MRMC) comparative effectiveness study is mentioned in the provided text. The study focuses on comparing the Sapphire Detachable Fibered Coil System against a predicate device through bench, animal, and physician evaluations, rather than assessing human reader improvement with or without AI assistance.

6. Standalone (Algorithm Only) Performance

This device is a physical medical device (embolization coil system), not an AI-powered diagnostic or therapeutic algorithm. Therefore, "standalone (algorithm only without human-in-the-loop performance)" is not applicable to this submission.

7. Type of Ground Truth Used

Based on the descriptions:

  • Bench Testing: The ground truth for bench testing is inherent in established engineering and physicochemical standards and specifications for material properties, mechanical performance, and device functionality.
  • Animal Testing: The ground truth for animal testing would be based on physiological and anatomical observations, angiographic assessments, and potentially histopathological evaluations in the animal models. The comparison is made against the performance of the predicate device in a living system.
  • Physician Device Evaluation: The ground truth for physician evaluations is based on the subjective and objective assessments of experienced medical professionals regarding the device's ease of use, handling, visualization, and overall performance in a simulated or real clinical environment (though the nature of the evaluation is not fully detailed to determine if it's purely simulated or involves actual clinical use).

8. Sample Size for the Training Set

Since this is a physical medical device and not an AI/ML algorithm requiring a training set, the concept of a "training set" and its sample size is not applicable.

9. How the Ground Truth for the Training Set was Established

As mentioned above, this section is not applicable to the Sapphire Detachable Fibered Coil System as it is not an AI/ML device.

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AUG 2 0 2003

K03 i852/P.13

Premarket Notification (510(k) for Sapphire Detachable Fibered C

510(k) Summary
Trade Name:Sapphire Detachable Fiber Coils
Generic Name:Artificial Embolization Coil
Classification:Class III, 21 CFR 882.5950
Submitted By:Micro Therapeutics, Inc.
2 Goodyear
Irvine, California 92618
Contact:Florin Truuvert

Predicate Device:

Micro Therapeutics, Inc.

NumberDescriptionPredicate ForClearance Date
K993418Fibered GDC VortX ShapeGuglielmi Detachable CoilSapphire Fibered Helixand Cyclone1/21/2000

Device Description

The Sapphire Detachable Coil (SDC) is manufactured from a platinum alloy wire which is first wound into primary coil and then formed into a secondary helical shape. The coil is welded to a positioning wire, which consist of ground stainless steel core wire with a stainless steel coil laser welded at the distal end and a Teflon outer jacket. The coil is detached by the battery operated power supply (Sapphire Detachment System, SDS), which dissolves a small detachment element between the emboliozation coil and the positioning wire. The fibered coil is manufactured with nylon fibers secured into the primary coil. The fibered coils are available in two shapes (Helix and Cyclone) and different sizes.

Indication For Use

The Sapphire Detachable Coils are intended for the endovascular embolization of intracranial aneurysms that - because of their morphology, their location, or the patient's general medical condition - are considered by the treating neurosurgical team to be a) very high risk for management by traditional operative techniques, or b) be inoperable.

The intended uses of the Sapphire fiber coils are narrowed relative to the predicate device GDC, but still fall within the 510(k) cleared intended use.

Sapphire Detachable Fibered Coil - The Sapphire fibered coil is intended for embolization of neurovascular abnormalities such as arteriovenous malformations (AVMs) and arteriovenous fistulae. The Fibered Sapphire is also intended for arterial and venous embolizations in the peripheral vasculature.

{1}------------------------------------------------

K031852/P2/3

Micro Therapeutics, Inc. Premarket Notification (510(k) for Sapphire Detachable Fibered Coil System

Verification and Test Summary Table

Bench TestingSapphire Fibered Coils
Coil Strength (Coil Deformation and Softness Testing)Meet established acceptance criteria
Ease of DeliveryMeet established acceptance criteria
Reliability After Fatigue & Premature DetachmentMeet established acceptance criteria
Tensile Strength of Coil & Detachment ZoneMeet established acceptance criteria
Tensile Strength of Delivery WireMeet established acceptance criteria
Delivery Wire FlexibilityMeet established acceptance criteria
Detachment TimeMeet established acceptance criteria
RadiopacityMeet established acceptance criteria
Particulate Generation of Detachment ZoneMeet established acceptance criteria
Aging and Shelf Life (3 year)Meet established acceptance criteria
Fiber Pull OutMeet established acceptance criteria
Fiber EnduranceMeet established acceptance criteria
Packaging validation after 3-year accelerated agingMeet established acceptance criteria
Animal TestingComparison to the Predicate Device
Coil Per Aneurysm (Avg./S.D.)Comparable
Detachment Time (seconds)Comparable
Coil Detachment Reliability (detachment attempts/coil)The Sapphire demonstrated higher reliability
Post Embolization Angiographic AssessmentComparable
Angiographic Assessment One-Month Follow-UpComparable
Angiographic Assessment Three-Month Follow-UpComparable
Physician Device EvaluationAcceptance Criteria
Ease of Coil PreparationComparable
Ability to move coil within CatheterComparable
AccessAcceptance Criteria
Ability to Place catheter tip in desired locationComparable
Trackability, Friction of coil through catheterComparable
Coil VisualizationAcceptance Criteria
Fluoroscopic visibility of CoilComparable
Fluoroscopic visibility of Detachment MarkersComparable
Coil Delivery ProcedureAcceptance Criteria
Ability to Position Coil in SacComparable
Detachment TimeComparable
Ability to Pack Aneurysm SacComparable
Ability to RepositionComparable
Ease of use of the SDS Detachment SystemComparable
Coil Positional Stability/Aneurysm OcclusionComparable
OverallAcceptance Criteria
Ease of UseComparable
Overall performanceComparable
MRI CompatibilityCompatible with 1.5 Tesla

. •

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K031852/P3/3

Micro Therapeutics, Inc. Premarket Notification (510(k) for Sapphire Detachable Fibered Coil System

Summary of Substantial Equivalence

The above comparison table demonstrates the technological similarity and equivalency of the Sapphire fibered coils compared with the predicate device, Target GDC fibered coils. The two devices have the same intended use,

  • Use the same operating principle,
  • Incorporate the same basic design, .
  • Have the same Intended Use, ●
  • Are packaged and sterilized using similar materials and processes.

In summary, the Sapphire fibered coils described in this submission are, in our opinion, substantially equivalent to the predicate device.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" are arranged in a circular pattern around the eagle. The eagle is black, and the text is also black. The logo is simple and recognizable.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 2 0 2003

Ms. Florin Truuvert Manager, Regulatory Affairs Micro Therapeutics, Inc. 2 Goodyear Irvine, California 92618

Re: K031852

Trade/Device Name: Sapphire Detachable Fibered Coil System Regulation Number: 21 CFR 882.5950 Regulation Name: Artificial embolization device Regulatory Class: III Product Code: HCG Dated: June 13, 2003 Received: June 24, 2003

Dear Ms. Truuvert:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Ms. Florin Truuvert

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-4659. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

Mark N. Melson

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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K031852

0

Indications for Use Statement

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name:

Sapphire Detachable Fibered Coil System

Indications for Use:

Sapphire Detachable Coils (Non-Fiber)

The Sapphire Detachable Coils are intended for the endovascular embolization of intracranial aneurysms that - because of their morphology, their location, or the patient's general medical condition are considered by the treating neurosurgical team to be a) very high risk for management by traditional operative techniques, or b) be inoperable.

The intended uses of the Sapphire fiber coils are narrowed relative to the predicate device GDC, but still fall within the 510(k) cleared intended use.

Sapphire Detachable Fibered Coil - The Sapphire fibered coil is intended for embolization of neurovascular abnormalities such as arteriovenous malformations (AVMs) and arteriovenous fistulae. The Fibered Sapphire is also intended for arterial and venous embolizations in the peripheral vasculature.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription UseOR (Per 21 CFR 801.109)Over the Counter Use
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(Division Sign-Off)
Division of General, Restorative and Neurological Devices

510(k) NumberK031852
------------------------

§ 882.5950 Neurovascular embolization device.

(a)
Identification. A neurovascular embolization device is an intravascular implant intended to permanently occlude blood flow to cerebral aneurysms and cerebral ateriovenous malformations. This does not include cyanoacrylates and other embolic agents, which act by polymerization or precipitation. Embolization devices used in other vascular applications are also not included in this classification, see § 870.3300.(b)
Classification. Class II (special controls.) The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance Document: Vascular and Neurovascular Embolization Devices.” For availability of this guidance document, see § 882.1(e).