K Number
K042539
Device Name
GDC-10 360 DEGREE COIL SR; GDC-10 360 DEGREE SOFT COIL SR; GDC-18 360 DEGREE COIL
Date Cleared
2004-10-19

(29 days)

Product Code
Regulation Number
882.5950
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Guglielmi Detachable Coil (GDC) is intended for embolizing certain 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) inoperable, and for embolizing other vascular malformations such as arteriovenous malformations and arteriovenous fistulae of the neurovasculature. The GDC is also intended for arterial and venous embolizations in the peripheral vasculature.
Device Description
The GDC system consists of GDC power supply, GDC occlusion coil attached to a delivery wire, set of GDC connecting cables, patient return electrode, two 9-volt batteries, each of which is sold separately. The occlusion coil is detached by electrolytically dissolving a small portion of the delivery wire upon desired placement of the coil in the anatomy. GDC occlusion coils are manufactured from platinum wire which is first wound into a primary coil and then formed into a secondary helical shape. Coils are attached to a delivery wire, which consists of a ground stainless-steel core wire with a stainless-steel coil welded at the distal end and a Teflon® outer jacket. The delivery wire is similar to that employed for the predicate GDC devices cleared variously under K991139, K001183 and K030475. The GDC Power Supply is a battery-operated, self-contained unit designed to initiate and control the electrolytic detachment of a GDC coil inside an aneurysm. Each time the power supply is turned on, the unit defaults to the 1.0 mA current setting. Pressing the "Current" switch one time changes the setting to the .05 mA current setting; pressing a second time changes the setting to 0.75 mA; pressing a third time returns the unit to the default 1.0 mA setting. Each time the switch is pressed, the current display flashes the new current setting. The GDC Power Supply is designed to apply a constant current through the GDC System and to detect when coil detachment has occurred. It maintains a constant current by: 1) sensing the amount of resistance to current flow through the GDC System, and 2) adjusting the voltage needed to maintain the desired current setting. It is also designed to identify subtle changes in the way current is flowing through the GDC System and to recognize those changes which indicate detachment. Once those patterns are identified, the GDC Power Supply signals detachment and stops the flow of current through the GDC System.
More Information

No
The description focuses on the mechanical and electrical aspects of the device (coil detachment via electrolysis, power supply controlling current and detecting detachment) and does not mention any AI/ML components or functions.

Yes
The device is described as "embolizing certain intracranial aneurysms" and "embolizing other vascular malformations," which indicates it is used for medical treatment or therapy.

No

The device is an embolization coil system used to treat aneurysms and vascular malformations by occluding them, which is a therapeutic rather than a diagnostic function.

No

The device description clearly outlines multiple hardware components including the coil, delivery wire, power supply, cables, and electrode. While the power supply has software to control detachment, the device is not solely software.

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

Here's why:

  • Intended Use: The intended use clearly describes a device used for embolizing vascular structures within the body (intracranial aneurysms, arteriovenous malformations, arteriovenous fistulae, and peripheral vasculature). IVDs are designed to examine specimens from the body (like blood, urine, tissue) to provide information about a person's health.
  • Device Description: The device description details a system for delivering and detaching a coil inside the patient's anatomy. This is an interventional procedure, not an in vitro diagnostic test.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, reagents, or any of the typical components or processes associated with in vitro diagnostics.

The Guglielmi Detachable Coil (GDC) is a therapeutic medical device used for embolization procedures.

N/A

Intended Use / Indications for Use

The Guglielmi Detachable Coil (GDC) is intended for embolizing certain 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) inoperable,

and for embolizing other vascular malformations such as arteriovenous malformations and arteriovenous fistulae of the neurovasculature.

The GDC is also intended for arterial and venous embolizations in the peripheral vasculature.

Product codes

HCG

Device Description

The GDC system consists of

  • GDC power supply
  • GDC occlusion coil attached to a delivery wire
  • set of GDC connecting cables
  • patient return electrode
  • two 9-volt batterics

each of which is sold separately.

The occlusion coil is detached by electrolytically dissolving a small portion of the delivery wire upon desired placement of the coil in the anatomy.

GDC occlusion coils are manufactured from platinum wire which is first wound into a primary coil and then formed into a secondary helical shape.

Coils are attached to a delivery wire, which consists of a ground stainless-steel core wire with a stainless-steel coil welded at the distal end and a Teflon® outer jacket. The delivery wire is similar to that employed for the predicate GDC devices cleared variously under K991139, K001183 and K030475.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Intracranial, neurovasculature, peripheral vasculature (arterial and venous)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Treating neurosurgical team

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)

Test or Point of ComparisonGDC-10 360° Coil SR GDC®-10 360° Soft Coil SR GDC-18 360° Coil
Tensile StrengthMeets acceptance criteria.
FrictionMeets acceptance criteria.
Detachment TimeNo change made which would affect this test.
Deployment / Retraction ForceMeets acceptance criteria.
Tip Ball StrengthMeets acceptance criteria.
Coil StiffnessMeets acceptance criteria.
Heating Effect of ElectrolysisNo change made which would affect this test.
Heating Effect of MRIMeets acceptance criteria.
Electrostatic DischargeNo change made which would affect this test.
Electromagnetic Compatibility- Radiated SusceptibilityNo change made which would affect this test.
Electromagnetic Compatibility- Radiated Emissions Class BNo change made which would affect this test.
Electromagnetic Compatibility- Magnetic ImmunityNo change made which would affect this test.
Operating System Test (Assembly Source Code)No change made which would affect this test.

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

Not Found

Predicate Device(s)

K991139, K001083, K030475

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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).

0

OCT 1 9 2004

K042539 page 1/7

Special 510(k): Boston Scientific Neurovascular's GDC® 360° Coils

a. Summary Of Safety And Effectiveness

Contact Person

Jim Leathley Regulatory Affairs Project Manager Boston Scientific Neurovascular 47900 Bayside Parkway Fremont, CA. 94538

Trade Name

Guglielmi Detachable Coil (GDC®), Class III

Common Name

Occlusion Coil

Classification Name

Artificial Embolization Device (21 CFR Section 882.5950)

Predicate Devices

NumberDescriptionPredicate forClearance Date
K991139
(Boston
Scientific /
Target)Guglielmi Detachable
Coil (GDC) System with
Version 4 Modificationscoil design of:
GDC-10 360° Coil SR
GDC-10 360° Soft Coil SR
GDC-18 360° Coil22 Dec. 1999
K001083
(Boston
Scientific /
Target)Guglielmi Detachable
Coil, Additional GDC
Version 4 Modificationscoil design of:
GDC-10 360° Coil SR
GDC-10 360° Soft Coil SR
GDC-18 360° Coil3 May 2000
K030475
(Boston
Scientific /
Target)Guglielmi Detachable
Coil, Modification of a
single component of the
GDC Stretch Resistant
Coil (Anchor 'Twister' to
Anchor 'Chain')Anchor Chain component
used on:
GDC-10 360° Coil SR
GDC-10 360° Soft Coil SR14 March 2003

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

September 2004

Page 1 of 7

1

K042539 page 2/7

Intended Use

GDC Power Supply

Boston Scientific Neurovascular's Guglielmi Detachable Coil (GDC) Power Supply is intended for use with all versions of Boston Scientific Neurovascular's Guglielmi Detachable Coils in the embolization of intracranial aneurysms and other vascular malformations of the neuro and peripheral vasculature.

Guglielmi Detachable Coil

The Guglielmi Detachable Coil (GDC) is intended for embolizing certain 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) inoperable,
    and for embolizing other vascular malformations such as arteriovenous malformations and arteriovenous fistulae of the neurovasculature.

The GDC is also intended for arterial and venous embolizations in the peripheral vasculature.

Device Description

The GDC system consists of

  • · GDC power supply
  • · GDC occlusion coil attached to a delivery wire
  • · set of GDC connecting cables
  • · patient return electrode
  • · two 9-volt batterics

each of which is sold separately.

The occlusion coil is detached by electrolytically dissolving a small portion of the delivery wire upon desired placement of the coil in the anatomy.

GDC occlusion coils are manufactured from platinum wire which is first wound into a primary coil and then formed into a secondary helical shape.

Coils are attached to a delivery wire, which consists of a ground stainless-steel core wire with a stainless-steel coil welded at the distal end and a Teflon® outer jacket. The delivery wire is similar to that employed for the predicate GDC devices cleared variously under K991139, K001183 and K030475.

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

September 2004

Page 2 of 7

2

K042539 page 3/7

The GDC Power Supply is a battery-operated, self-contained unit designed to initiate and control the electrolytic detachment of a GDC coil inside an aneurysm.

Each time the power supply is turned on, the unit defaults to the 1.0 mA current setting. Pressing the "Current" switch one time changes the setting to the .05 mA current setting; pressing a second time changes the setting to 0.75 mA; pressing a third time returns the unit to the default 1.0 mA setting. Each time the switch is pressed, the current display flashes the new current setting.

The GDC Power Supply is designed to apply a constant current through the GDC System and to detect when coil detachment has occurred. It maintains a constant current by:

    1. sensing the amount of resistance to current flow through the GDC System, and
    1. adjusting the voltage needed to maintain the desired current setting. It is also designed to identify subtle changes in the way current is flowing through the GDC System and to recognize those changes which indicate detachment.

Once those patterns are identified, the GDC Power Supply signals detachment and stops the flow of current through the GDC System.

Accessories Description

Accessories consist of the following:

  • · Two connecting cables, one black (274 cm long), the other red (152 cm long)
  • Two standard 9 volt alkaline batteries

3

Technological Characteristics Comparison (to predicate devices)

Coil Dimensional Attributes

| | GDC-10 360° Coil SR
GDC®-10 360º Soft Coil SR
GDC-18 360° Coil |
|-------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------|
| Coil Wire OD | Same sizes as used with predicate devices |
| Primary Coil OD | Two new primary coil sizes used with GDC-10 360° Coils; both are
within the range of sizes used across all current GDC coils |
| Secondary Coil OD | Expanded range of available sizes |
| Distal Tip Diameter
(Stretch Resistant Coils only) | Larger distal tip diameters to accommodate new primary coil sizes |
| Delivery Wire Length | Same as for predicate devices |
| Delivery Wire Proximal OD | Same as for predicate devices |
| Delivery Wire Distal OD | Same as for predicate devices |

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

September 2004

Page 4 of 7

4

K042539 page 5/7

Technological Characteristics Comparison (cont.)

Materials

| | GDC-10 360° Coil SR
GDC®-10 360° Soft Coil SR
GDC-18 360° Coil |
|---------------------------------------------------------------------------|----------------------------------------------------------------------|
| Main Coil | Same as predicate devices |
| Stretch Resistant Thread
(GDC-10 360° and GDC-10 360° Soft Coils only) | Same as predicate devices |
| Main Coil / delivery wire junction tubing | Same as predicate devices |
| Delivery Wire | |
| Core wire w/coating | Same as predicate devices |
| Proximal Coil | Same as predicate devices |
| Proximal Marker Coil | Same as predicate devices |
| Sheath, Delivery Wire (heat shrink tubing) | Same as predicate devices |
| Proximal Tubing | Same as predicate devices |
| Bushing | Same as predicate devices |
| Anchor Chain
(GDC-10 360° and GDC-10 360° Soft Coils only) | Same as predicate devices |
| Inner Coil | Same as predicate devices |

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

.

September 2004

5

K042539 page 6/7

Technological Characteristics Comparison (cont.)

Power Supply

| | GDC-10 360° Coil SR
GDC®-10 360º Soft Coil SR
GDC-18 360° Coil |
|-----------------------|----------------------------------------------------------------------|
| Power | Same as for predicate devices |
| Batteries | Same as for predicate devices |
| Expected Battery Life | Same as for predicate devices |
| Red Cable | Same as for predicate devices |
| Black Cable | Same as for predicate devices |
| Current Settings | Same as for predicate devices |
| Current | Same as for predicate devices |
| Voltage | Same as for predicate devices |
| Operating Temp. | Same as for predicate devices |
| Storage Temp. | Same as for predicate devices |
| Relative Humidity | Same as for predicate devices |
| Unit Size | Same as for predicate devices |
| Unit Weight | Same as for predicate devices |

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

September 2004

Page 6 of 7

6

K042539 Page 7/7

| Test or Point of Comparison | GDC-10 360° Coil SR
GDC®-10 360° Soft Coil SR
GDC-18 360° Coil |
|--------------------------------------------------------------|----------------------------------------------------------------------|
| Tensile Strength | Meets acceptance criteria. |
| Friction | Meets acceptance criteria. |
| Detachment Time | No change made which would affect this test. |
| Deployment / Retraction Force | Meets acceptance criteria. |
| Tip Ball Strength | Meets acceptance criteria. |
| Coil Stiffness | Meets acceptance criteria. |
| Heating Effect of Electrolysis | No change made which would affect this test. |
| Heating Effect of MRI | Meets acceptance criteria. |
| Electrostatic Discharge | No change made which would affect this test. |
| Electromagnetic Compatibility-
Radiated Susceptibility | No change made which would affect this test. |
| Electromagnetic Compatibility-
Radiated Emissions Class B | No change made which would affect this test. |
| Electromagnetic Compatibility-
Magnetic Immunity | No change made which would affect this test. |
| Operating System Test
(Assembly Source Code) | No change made which would affect this test. |

Verification Test Summary Table: Predicate GDC Devices vs GDC-10 and GDC-18 360° Coils

Special 510(k) Notification, Boston Scientific Neurovascular GDC®-10 and GDC-18 360° Coils

September 2004

Page 7 of 7

7

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/7/Picture/12 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three stripes representing the department's mission. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 1 9 2004

Mr. James Leathley Regulatory Affairs Project Manager Boston Scientific Neurovascular 47900 Bayside Parkway Fremont, California 94538

Re: K042539

KU42339
Trade/Device Name: Guglielmi Detachable Coil (GDC =10 360° Coil SR; GDC-10 360° Soft Coil SR, and GDC-18 360° Coil) Regulation Number: 21 CFR 882.5950 Regulation Name: Artifical embolization device Regulatory Class: III Product Code: HCG Dated: September 17, 2004 Received: September 20, 2004

Dear Mr. Leathley:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your beeemined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encreativent of the enactment date of the Medical Device Amendments, or to conniner of the reserved in accordance with the provisions of the Federal Food, Drug, de vices that have been require approval of a premarket approval application (PMA). and Cosmetic Fee (110) has the device, subject to the general controls provisions of the Act. The r ou may) ateres, provisions of the Act include requirements for annual registration, listing of general controls pro resuring 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 If your device is exassinod (vonal controls. Existing major regulations affecting your device can may be subject to back adderal 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 r load be actived a determination that your device complies with other requirements of the Act that I Dr Has maas a a regulations administered by other Federal agencies. You must or any I 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.

8

Page 2 - Mr. James Leathley

This letter will allow you to begin marketing your device as described in your Section 510(k) I his letter witi anow you to oegin manteing of substantial equivalence of your device to a legally premaired notincation. The PDA maing of casification 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 If you desire specific advice ion your ac now of the regulation entitled, Colliact the Office of Companisonarket notification" (21CFR Part 807.97). You may obtain Misolanumig by reference to premailsonibilities under the Act from the Division of Small other general international and Consumer Assistance at its toll-free number (800) 638-2041 or Manufacturers, International and Soless http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

uriam 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

9

Image /page/9/Picture/1 description: The image shows the logo for Boston Scientific. The words "Boston Scientific" are stacked on top of each other. The font is a serif font and the text is black.

INDICATIONS FOR USE STATEMENT

510(k) Number: K042539

Device Name: Guglielmi Detachable Coil (GDC®-10 360° Coil SR, GDC-10 360° Soft Coil SR and GDC-18 360° Coil)

Indications for Use:

The Guglielmi Detachable Coil (GDC) is intended for embolizing certain 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) inoperable,

and for embolizing other vascular malformations such as arteriovenous malformations and arteriovenous fistulae of the neurovasculature.

The GDC is also intended for arterial and venous embolizations in the peripheral vasculature.

V Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Miriam C. Provost

(Division Sign-Off)

Division of Gen eral. Restorative.

Special 510(k) Notification, Boston Scientifient Regio Devices

GDC®-10 and GDC-18 360° Coils

Page 1 of 1

September 2004

K642539 510(k) Number_________________________________________________________________________________________________________________________________________________________________