K Number
K061332
Device Name
FILTERWIRE EZ EMBOLIC PROTECTION SYSTEM (2.25 MM-3.5 MM)
Date Cleared
2006-08-11

(91 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The FilterWire EZ Embolic Protection System is indicated for use as a guide wire and embolic protection system to contain and remove embolic material (thrombus/debris) while performing angioplasty and stenting procedures in coronary saphenous vein bypass grafts. The diameter of the artery at the site of filter loop placement should be between 2.25 mm and 5.5 mm. The safety and effectiveness of this device as an embolic protection system has not been established in cerebral, carotid and peripheral vasculature or in treating native coronaries, including acute myocardial infarction.
Device Description
The subject FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) consists of the same four main components as the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) cleared under K051984. These components are: - · A Protection Wire (0.014 in. [0.36 mm] guide wire and integrated filter loop) that incorporates a circular/oval-shaped structure (filter loop assembly), which supports a thin, porous, filter membrane designed to contain and remove embolic material while maintaining blood flow. - · An EZ Delivery Sheath, a low-profile sheath that constrains the filter on the protection wire for delivery to the site of filter loop placement. It is prepackaged with the protection wire for coaxial delivery and has a slit for easy removal in a peel-away fashion. - · An EZ Retrieval Sheath is intended to negotiate through the anatomy over the protection wire to retrieve the filter. The sheath is designed to track easily to the filter without catching on obstacles such as stents. The sheath has a radiopaque marker and is silicone coated. - · A tool kit containing one peel-away introducer, one wire torquer and one hemostasis valve dilator
More Information

No
The device description and intended use focus on mechanical components for embolic protection during angioplasty and stenting. There is no mention of AI, ML, image processing, or data analysis that would suggest the use of such technologies.

No
This device is an embolic protection system designed to contain and remove embolic material during angioplasty and stenting procedures, which is a procedural tool rather than a therapeutic device that directly treats a disease or condition.

No

The document describes the device's function as containing and removing embolic material during angioplasty and stenting procedures, which is a therapeutic intervention, not a diagnostic one.

No

The device description clearly outlines multiple physical components including a guide wire, filter loop, delivery sheath, retrieval sheath, and a tool kit. These are all hardware components, not software.

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

Here's why:

  • Intended Use: The intended use describes a device used within the body during a medical procedure (angioplasty and stenting) to capture embolic material. This is an in vivo application.
  • Device Description: The description details physical components like wires, sheaths, and a filter membrane designed for insertion into blood vessels. These are not components typically found in IVD devices, which are used to test samples outside the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), reagents, or laboratory testing, which are hallmarks of IVD devices.

Therefore, the FilterWire EZ Embolic Protection System is a medical device used in vivo, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The FilterWire EZ Embolic Protection System is indicated for use as a guide wire and embolic protection system to contain and remove embolic material (thrombus/debris) while performing angioplasty and stenting procedures in coronary saphenous vein bypass grafts. The diameter of the artery at the site of filter loop placement should be between 2.25 mm and 5.5 mm.

The safety and effectiveness of this device as an embolic protection system has not been established in cerebral, carotid and peripheral vasculature or in treating native coronaries, including acute myocardial infarction.

Product codes

NFA

Device Description

The subject FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) consists of the same four main components as the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) cleared under K051984. These components are:

  • · A Protection Wire (0.014 in. [0.36 mm] guide wire and integrated filter loop) that incorporates a circular/oval-shaped structure (filter loop assembly), which supports a thin, porous, filter membrane designed to contain and remove embolic material while maintaining blood flow.
  • · An EZ Delivery Sheath, a low-profile sheath that constrains the filter on the protection wire for delivery to the site of filter loop placement. It is prepackaged with the protection wire for coaxial delivery and has a slit for easy removal in a peel-away fashion.
  • · An EZ Retrieval Sheath is intended to negotiate through the anatomy over the protection wire to retrieve the filter. The sheath is designed to track easily to the filter without catching on obstacles such as stents. The sheath has a radiopaque marker and is silicone coated.
  • · A tool kit containing one peel-away introducer, one wire torquer and one hemostasis valve dilator

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

coronary saphenous vein bypass grafts; artery at the site of filter loop placement

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)

Non-Clinical Performance Data
Where appropriate, testing conformed to the requirements of 21 CFR Part 58, Good Laboratory Practices (GLP). Specifically, non-clinical tests conducted for the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) showed the device met its design-input criteria, and is safe and effective for its intended use.

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

Not Found

Predicate Device(s)

K051984

Reference Device(s)

K032884, K052880

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.1250 Percutaneous catheter.

(a)
Identification. A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.(b)
Classification. Class II (performance standards).

0

K061332
AUG 11 2006

Section 5

510(k) Summary

"510(k) Summary" as required by section 807.92(c)

5.1 General Provisions

| Submitter's Name
and Address | Boston Scientific Corporation
2011 Stierlin Court
Mountain View, CA 94043-4655, U.S.A. |
|---------------------------------|-------------------------------------------------------------------------------------------------------|
| Contact Person | Debbie McIntire
Senior Regulatory Affairs Specialist
Tel: (650) 623-1703
Fax: (650) 623-1610 |
| Classification Name | 21CFR870.1250, Percutaneous Catheter |
| Common or Usual Name | Distal embolic protection guide wire |
| Proprietary Name | Boston Scientific FilterWire EZ Embolic Protection
System |
| Manufacturing Facilities | Boston Scientific Corporation
2011 Stierlin Court
Mountain View, CA 94043-4655, U.S.A. |

5.2 Name of Predicate Device

The Boston Scientific FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) is substantially equivalent in design and intended use to the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) cleared under K051984.

5.3 Device Description

The subject FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) consists of the same four main components as the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) cleared under K051984. These components are:

1

  • · A Protection Wire (0.014 in. [0.36 mm] guide wire and integrated filter loop) that incorporates a circular/oval-shaped structure (filter loop assembly), which supports a thin, porous, filter membrane designed to contain and remove embolic material while maintaining blood flow.
  • · An EZ Delivery Sheath, a low-profile sheath that constrains the filter on the protection wire for delivery to the site of filter loop placement. It is prepackaged with the protection wire for coaxial delivery and has a slit for easy removal in a peel-away fashion.
  • · An EZ Retrieval Sheath is intended to negotiate through the anatomy over the protection wire to retrieve the filter. The sheath is designed to track easily to the filter without catching on obstacles such as stents. The sheath has a radiopaque marker and is silicone coated.
  • · A tool kit containing one peel-away introducer, one wire torquer and one hemostasis valve dilator

5.4 Intended Use

The FilterWire EZ Embolic Protection System is indicated for use as a guide wire and embolic protection system to contain and remove embolic material (thrombus/debris) while performing angioplasty and stenting procedures in coronary saphenous vein bypass grafts. The diameter of the artery at the site of filter loop placement should be between 2.25 mm and 5.5 mm.

The safety and effectiveness of this device as an embolic protection system has not been established in cerebral, carotid and peripheral vasculature or in treating native coronaries, including acute myocardial infarction.

ર્સ્ડ Summary of Technological Characteristics

The Filter Wire EZ Embolic Protection System (2.25 mm - 3.5 mm) indicated for use in saphenous vein bypass grafts is equivalent to the Filter Wire EZ Embolic Protection System (2.25 mm - 3.5 mm) cleared under K051984 in that the intended use, principles of operation, design and materials are similar. The following design attributes are the same or similar for the subject device and the predicate device:

Design Attributes

Single Operator Exchange delivery systems Filter-based technology Nitinol® filter/basket component Bionate™ polyurethane filter membrane

"The FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) is an extension of the FilterWire EZ Embolic Protection System family (sizes 3.5 mm - 5.5 mm) cleared under K032884 and K052880; the indications for use in the combined directions for use (for the FilterWire EZ family) will reference the entire vessel diameter range of 2.25 mm to 5.5 mm.

2

Compatibility with .014 in. guide wires Compatibility with 6F guide catheters Available in 2 wire lengths; 190 cm and 300 cm Radiopaque guide wire tips Radiopaque markers on filter loop

Non-Clinical Performance Data ર્સ્ડ

Where appropriate, testing conformed to the requirements of 21 CFR Part 58, Good Laboratory Practices (GLP). Specifically, non-clinical tests conducted for the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) showed the device met its design-input criteria, and is safe and effective for its intended use.

5.7 Statement of Substantial Equivalence

Based on a comparison of design, fundamental technology, intended use, results of in-vitro testing, in-vivo testing, biocompatibility, and packaging, Boston Scientific considers the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) to be substantially equivalent to the FilterWire EZ Embolic Protection System (2.25 mm - 3.5 mm) (K051984).

3

Image /page/3/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird-like symbol with three curved lines representing its wings or feathers. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" is arranged in a circular pattern around the symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 1 1 2006

Boston Scientific Corporation C/O Ms. Debbie McIntire Senior Regulatory Affairs Specialist 2011 Stierlin Court Mountain View, CA 94043-4655

Re: K061332

Trade/Device Name: FilterWire EZ Embolic Protection System (2.25mm - 3.5mm) Regulation Number: 21 CFR 870.1250 Regulation Name: Distal Embolic Protection Guidewire Regulatory Class: Class II Product Code: NFA Dated: August 4, 2006 Received: August 4, 2006

Dear Ms. McIntire:

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.

4

Page 2 – Ms. Debbie McIntire

Please be advised that FDA's issuance of a substantial equivalence determination does not mean r lease oc advised that I Dr is lossants over device complies with other requirements of the Act that i DA has made a develations administered by other Federal agencies. You must bir any I cuttlar statures und regulations and limited to: registration and listing (21 Comply with an the 11ct 821 CFR Part 801); good manufacturing practice requirements as set CI K ratt 607); adoning (21 CFR Part 820); and if applicable, the electronic forth in the quant) by events (Sections 531-542 of the Act); 21 CFR 1000-1050. product radiation control provisions (Section (Section of the as described in your Section 510(k) This letter will and will your of substantial equivalence of your device to a legally premailer notificated. " ceresults 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 n you don't e ffice of Compliance at (240) 276-0120. 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 other general mional and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Bram D. Zuckerman, M.D.

Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Special 510(k): Device Modification FilterWire EZ™ Embolic Protection System (2.25 mm - 3.5 mm)

Section 3

Indications For Use

FilterWire EZ™ Embolic Protection System Device Name:

Indications for Use:

The indications for use for the FilterWire EZ Embolic Protection System are as follows:

The FilterWire EZ Embolic Protection System is indicated for use as a guide wire and embolic protection system to contain and remove embolic material (thrombus/debris) while performing angioplasty and stenting procedures in coronary saphenous vein bypass grafts. The diameter of the artery at the site of filter loop placement should be between 2.25 mm and 5.5 mm.

The safety and effectiveness of this device as an embolic protection system has not been established in cerebral, carotid and peripheral vasculature or in treating native coronaries, including acute myocardial infarction.

Prescription UseX
(Per 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use_ (Per 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)
(Division Sign-Off)
Division of Cardiovascular Devices
510(k) NumberK061332