K Number
K033237
Device Name
VASCULAR SOLUTIONS VARI-LASE ENDOVENOUS LASER CONSOLE
Date Cleared
2003-11-20

(45 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
VARI-LASE is indicated for the treatment of varicose veins and varicosities associated with superficial reflux of the Greater Saphenous Vein.
Device Description
The VARI-LASE Laser is a semiconducter diode laser operating at 810 ± 20 nanometers.
More Information

Not Found

No
The summary describes a laser device for treating varicose veins and does not mention any AI/ML components or functionalities.

Yes
The device is indicated for the "treatment of varicose veins and varicosities," which is a therapeutic purpose.

No

The device description clearly states "VARI-LASE is indicated for the treatment of varicose veins," indicating a therapeutic rather than diagnostic purpose.

No

The device description explicitly states it is a "semiconductor diode laser operating at 810 ± 20 nanometers," which is a hardware component. The performance studies also focus on testing the "laser console" against hardware standards.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the treatment of varicose veins and varicosities. IVDs are used for the diagnosis of diseases or conditions.
  • Device Description: The device is a laser used for treatment, not for analyzing biological samples.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), performing tests on these samples, or providing diagnostic information.

The device is a therapeutic device used for a medical procedure.

N/A

Intended Use / Indications for Use

The VARI-LASE laser is indicated for the treatment of varicose veins and varicosities associated with superficial reflux of the Greater Saphenous Vein.

Product codes (comma separated list FDA assigned to the subject device)

GEX

Device Description

The VARI-LASE Laser is a semiconducter diode laser operating at 810 ± 20 nanometers.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Greater Saphenous Vein

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Testing has been conducted to verify the laser console is in compliance with the following standards:
EN60601-1 Medical Electrical Equipment - Part 1: General Requirements For Safety"
EN60601-1-1 Medical Electrical Equipment - Part 1: General Requirements For Safety 1: Collateral Standard: Safety Requirements For Medical Electrical Systems
EN60601-2 Medical Electrical Equipment - Part 1-2: General Requirements For Safety - Collateral Standard: Electromagnetic Compatibility -
EN60601-1-4 Requirements And Tests Medical Electrical Equipment - Part 1-4. General Requirements For
EN60601-2-22 Safety - Collateral Standard: Programmable Electrical Medical Systems Medical Electrical Equipment - Part 2: Particular Requirements For safety - Section 2.22: Specification For Diagnostic And Therapeutic Laser Equipment

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K023543, K991659

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.

0

NOV 2 0 2003

KO33232 - 1 - 1 6 - 1

510(K) SUMMARY

Common/Usual Name:Laser Instrument
Product Trade Name:Vari-Lase Laser Console
Classification Name:Laser Surgical Instrument for use in General and Plastic Surgery and in
Dermatology 21 CFR 878-4810 (Product Code GEX)
Manufacturer:Vascular Solutions, Inc.
2495 Xcnium Lane North
Minneapolis, Minnesota 55441
Establishment Registration:2134812
Contact:Deborah Jensen
V. P., Regulatory Affairs, Clinical Affairs, and Quality Systems
(763) 656-4349 phone
(763) 656-4250 fax
Performance Standards:No performance standards have been developed under section 514 for
this device. The laser console is in compliance with the standards
established in 21 CFR 1040.
Device Description:The VARI-LASE Laser is a semiconducter diode laser operating at 810
± 20 nanometers.
Intended Use:The VARI-LASE laser is indicated for the treatment of varicose veins
and varicosities associated with superficial reflux of the Greater
Saphenous Vein.
Summary of Non-Clinical
Testing:Testing has been conducted to verify the laser console is in compliance
with the following standards:
EN60601-1Medical Electrical Equipment - Part 1: General Requirements For
Safety"
EN60601-1-1Medical Electrical Equipment - Part 1: General Requirements For Safety
1: Collateral Standard: Safety Requirements For Medical Electrical
Systems
EN60601-2Medical Electrical Equipment - Part 1-2: General Requirements For
Safety - Collateral Standard: Electromagnetic Compatibility -
EN60601-1-4Requirements And Tests
Medical Electrical Equipment - Part 1-4. General Requirements For
EN60601-2-22Safety - Collateral Standard: Programmable Electrical Medical Systems
Medical Electrical Equipment - Part 2: Particular Requirements For
safety - Section 2.22: Specification For Diagnostic And Therapeutic
Laser Equipment
Predicate Devices:Diomed 15/30 Plus Diomed, Inc. (K023543)
Medart 425P/426 Laser Consoles (K991659)
Conclusions:The VARI-LASE Laser is substantially equivalent to the identified
predicate devices based on a comparison of the indications for use
and the technological characteristics.

1

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 2 0 2003

Ms. Deborah Jensen Vice President, Regulatory Affairs, Clinical Affairs and Quality Systems Vascular Solutions, Inc. 2495 Xenium Lane North Minneapolis, Minnesota 55441

Re: K033237

Trade/Device Name: Vascular Solutions Vari-Lase™ Endovenous Laser Console Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology Regulatory Class: II Product Code: GEX Dated: September 30, 2003 Received: October 7, 2003

Dear Ms. Jensen:

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.

2

Page 2 - Ms. Deborah Jensen

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.

Miriam C. Provost

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

3

Indications for Use Statement

510(k) Number:

033237

Device Name:

Vascular Solutions Vari-Lase™ Endovenous Laser Console

Indications for Use:

VARI-LASE is indicated for the treatment of varicose veins and varicosities associated with superficial reflux of the Greater Saphenous Vein.

Miriam

(Division Sign-Off) (Division Sigil-On)
Division of General, Restorative Division of Sical Devices