K Number
K090357
Device Name
HYDROFRAME (HES)
Manufacturer
Date Cleared
2009-04-10

(57 days)

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

The HydroFrame HydroCoil Embolic System (HES) is intended for the endovascular embolization of intracranial aneurysms and other neurovascular abnormalities such as arteriovenous malformations and artiovenous fistula. The HES is also intended for vascular occlusion of blood vessels within the neurovascular system to permanently obstruct blood flow to an aneurysm or other vascular malformation and for arterial and venous embolization in the peripheral vasculature.

Device Description

The HydroFrame coils consist of implant coil made of platinum alloy with inner hydrogel core. The coils are designed in 3D spherical structure in various loop with miller hydroget core. he a V-Trak™ MCS delivery pusher via a polymer fillament. The delivery pusher contains radiopaque positioning markers at the distal end. The proximal end is inserted into a hand held battery powered V-Grip™ Detachment Controller. The proximal end is niscreed into nell onecry powered. Costroller Controller.

AI/ML Overview

This document describes the HydroFrame - HydroCoil Embolic System (HES), a neurovascular embolization device. The information provided is from a 510(k) summary (K090357) for FDA clearance. The "acceptance criteria" and "study that proves the device meets the acceptance criteria" in this context refer to the performance tests conducted to demonstrate substantial equivalence to previously cleared predicate devices, not a clinical trial with specific performance metrics like sensitivity/specificity.

Here's a breakdown of the requested information based on the provided text:

1. A table of acceptance criteria and the reported device performance

Acceptance Criteria (Bench Test)Reported Device Performance
Visual InspectionMet established criteria
Dimensional MeasurementMet established criteria
Simulated UseMet established criteria
Detachment TestMet established criteria
Detachment Zone TensileMet established criteria
Advancement/Retraction ForceMet established criteria
Coil to Coupler Weld TensileMet established criteria
Spring ConstantMet established criteria
Gel ExpansionMet established criteria

2. Sample size used for the test set and the data provenance

The document describes bench testing, which typically does not involve human subjects or clinical data. The "test set" in this case would refer to the physical units of the HydroFrame coils subjected to the various bench tests. The specific sample sizes for each test are not provided in this summary.

The data provenance is MicroVention, Inc., Aliso Viejo, California, U.S.A. The data is from prospective bench tests performed by the manufacturer to demonstrate the device's physical and functional properties.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

This question is not applicable to the type of testing described. Bench testing is a physical verification process against established engineering and design specifications. It does not involve medical experts establishing "ground truth" in the way clinical studies do (e.g., diagnosing a condition). The "ground truth" for these tests would be the pre-defined engineering specifications and performance targets for each test, which are determined by the manufacturer based on their design requirements and comparison to predicate devices.

4. Adjudication method for the test set

This is not applicable to bench testing as described. Adjudication methods (like 2+1, 3+1) are typically used in clinical studies or image review where multiple human readers are involved in making subjective assessments or diagnoses, and their disagreements need to be resolved. Bench tests involve objective measurements and comparisons against defined criteria.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This device is a physical medical implant (an embolic coil), not an AI-powered diagnostic or assistive tool. Therefore, the concept of human readers improving with or without AI assistance does not apply.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

No, a standalone algorithm performance study was not done. This device is a physical medical device, not an algorithm or AI system.

7. The type of ground truth used

The "ground truth" for the bench tests would be the established engineering specifications, design parameters, and performance criteria for each test (e.g., specific dimensions, tensile strengths, detachment forces, gel expansion rates). These criteria are derived from the device's design, manufacturing standards, and the performance characteristics of its predicate devices.

8. The sample size for the training set

This question is not applicable. There is no "training set" in the context of this device's testing, as it is a physical product and not an AI/machine learning model.

9. How the ground truth for the training set was established

This question is not applicable for the same reason as point 8.

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K090357 /P1/2

510(k) Summary

APR ] 0 2009

Trade Name:HydroFrame - HydroCoil Embolic System (HES)
Generic Name:Neurovascular Embolization Device
Classification:Class II, 21 CFR 882.5950
Submitter Nameand AddressMicroVention, Inc75 ColumbiaAliso Viejo, California U.S.A.
Contact Name:Florin TruuvertSenior Director, Worldwide Regulatory AffairsPhone: (949) 951-0516Fax: (949) 349-1360florin.truuvert@microvention.com
Predicate Device:510(k)K082461K080666DescriptionMicroVention, Bare Platinum Framing CoilsMicroVention, HydroSoft (HES)Clearance DateOct 2, 2008July 11, 2008

Device Description

The HydroFrame coils consist of implant coil made of platinum alloy with inner hydrogel core. The coils are designed in 3D spherical structure in various loop with miller hydroget core. he a V-Trak™ MCS delivery pusher via a polymer fillament. The delivery pusher contains radiopaque positioning markers at the distal end. The proximal end is inserted into a hand held battery powered V-Grip™ Detachment Controller. The proximal end is niscreed into nell onecry powered.
Costroller Controller.

Indication For Use

The HydroCoil Embolic System (HES) is intended for the endovascular embolization of intracranial aneurysms and other neurovascular abnormalities such as arteriovenous malformations and artiovenous fistula. The HES is also intended for vascular occlusion of blood vessels within the neurovascular system to permanently obstruct blood flow to an aneurysm or other vascular malformation and for arterial and venous embolization in the peripheral various values va

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K090357

P.2/2

Verification and Test Summary Table

Bench TestingResult
Visual InspectionMet established criteria
Dimensional MeasurementMet established criteria
Simulated UseMet established criteria
Detachment TestMet established criteria
Detachment Zone TensileMet established criteria
Advancement/Retraction ForceMet established criteria
Coil to Coupler Weld TensileMet established criteria
Spring ConstantMet established criteria
Gel ExpansionMet established criteria

Summary of Substantial Equivalence

The data presented in this submission demonstrates the technological similarity and equivalency of the HydroFrame coils when compared with the predicate device MicroVention Inc., Bare Platinum Framing Coils (K082461) and the HydroSoft coils (K08066).

The devices,

،

  • . Have the same intended use,
  • . Use the same operating principle,
  • . Incorporate the same basic design,
  • . Use similar construction and material,
  • Are packaged and sterilized using same material and processes. .

In summary, the HydroFrame coils described in this submission is, in our opinion, substantially equivalent to the predicate device.

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Image /page/2/Picture/1 description: The image is a black and white logo for the Department of Health & Human Services - USA. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the circumference. Inside the circle is a stylized graphic that resembles a bird in flight, composed of three curved lines that converge at the bottom.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MicroVention, Inc. c/o Florin Truuvert Senior Director, Worldwide Regulatory Affairs 75 Columbia. Suite A Aliso Viejo, CA 92656

APR 1 0 2009

Re: K090357

Trade/Device Name: HydroFrame Hydrocoil Embolic System (HES) Regulation Number: 21 CFR 882.5950 Regulatory Class: Class II Product Code: HCG, KRD Dated: February 10, 2009 Received: February 12, 2009

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.

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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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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If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please contact the CDRH/Office of Surveillance and Biometrics/Division of Postmarket Surveillance at 240-276-3464. For more information regarding the reporting of adverse events, please go to http://www.fda.gov/cdrh/mdr/.

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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

R. le. Mean, MD k

Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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K090357

Indications for Use

510(k) Number (if known): K090357

HydroFrame Hydrocoil Embolic System (HES) Device Name:

Indications For Use:

The HydroFrame HydroCoil Embolic System (HES) is intended for the endovascular embolization of intracranial aneurysms and other neurovascular abnormalities such as arteriovenous malformations and artiovenous fistula. The HES is also intended for vascular occlusion of blood vessels within the neurovascular system to permanently obstruct blood flow to an aneurysm or other vascular malformation and for arterial and venous embolization in the peripheral vasculature.

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

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

J.M.S.

(Division Si Division of Ophthalmic and Ear. Nose and Throat Devices

510(k) Number KC090357

Page 1 of 1

§ 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).