K Number
K113778
Device Name
EXCELSIOR XT-27 MICROCATHETER
Date Cleared
2012-04-20

(120 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Excelsior XT-27 Microcatheter is intended to assist in the delivery of diagnostic agents (such as contrast media), therapeutic agents, and non- liquid interventional devices (such as stents) that are indicated for use in the neurovasculature and with a catheter of 0.027 inches in inner diameter.
Device Description
The Excelsior® XT-27™ Microcatheter is a sterile, single lumen 0.027 in ID device with one tip marker designed to aid the physician in accessing distal vasculature when used with a guide catheter and steerable guidewire. Graded shaft stiffness ranging from a highly flexible tip to a semi-rigid proximal section aids the physician in tracking over selectively placed guidewires. A luer fitting located on the microcatheter hub is used for the attachment of accessories. One radiopaque tip marker is positioned at the distal tip of the device to facilitate fluoroscopic visualization. The Excelsior XT-27 Microcatheter is coated on the outer surface with Hydrolene™ coating which reduces friction during manipulation in the vessel. The Excelsior XT-27 Microcatheters are available in effective lengths of both 135cm (53.1 inch) and 150 cm (59.1 inch), with two distal shaft configurations achieved through distal shaft lengths of 6 cm (XT-27 model) and 18 cm (XT-27 Flex model). Both straight tip and Pre-Shaped versions are available.
More Information

No
The device description and performance studies focus on the physical characteristics and mechanical performance of a microcatheter, with no mention of AI or ML capabilities.

No.
The device is a microcatheter intended to assist in the delivery of diagnostic and therapeutic agents, but it is not itself a therapeutic device.

No

The device is a microcatheter intended to assist in the delivery of diagnostic agents, therapeutic agents, and non-liquid interventional devices. It is a delivery tool, not a device that itself performs a diagnostic function.

No

The device description clearly details a physical microcatheter with specific dimensions, materials, and features, indicating it is a hardware device.

Based on the provided information, the Excelsior XT-27 Microcatheter is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is used to assist in the delivery of diagnostic and therapeutic agents, as well as non-liquid interventional devices, within the neurovasculature. This is an interventional procedure performed in vivo (within the body).
  • Device Description: The description details a physical catheter designed for insertion into blood vessels.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens in vitro (outside the body), such as blood, tissue, or other bodily fluids, to provide information for diagnosis, monitoring, or screening.

IVD devices are typically used in laboratories or point-of-care settings to analyze biological samples. The Excelsior XT-27 Microcatheter is a medical device used directly within the patient's body for therapeutic and diagnostic delivery purposes.

N/A

Intended Use / Indications for Use

The Excelsior XT-27 Microcatheter is intended to assist in the delivery of diagnostic agents (such as contrast media), therapeutic agents, and non- liquid interventional devices (such as stents) that are indicated for use in the neurovasculature and with a catheter of 0.027 inches in inner diameter.

Product codes

DQY, KRA

Device Description

The Excelsior® XT-27™ Microcatheter is a sterile, single lumen 0.027 in ID device with one tip marker designed to aid the physician in accessing distal vasculature when used with a guide catheter and steerable guidewire. Graded shaft stiffness ranging from a highly flexible tip to a semi-rigid proximal section aids the physician in tracking over selectively placed guidewires. A luer fitting located on the microcatheter hub is used for the attachment of accessories. One radiopaque tip marker is positioned at the distal tip of the device to facilitate fluoroscopic visualization. The Excelsior XT-27 Microcatheter is coated on the outer surface with Hydrolene™ coating which reduces friction during manipulation in the vessel.

The Excelsior XT-27 Microcatheters are available in effective lengths of both 135cm (53.1 inch) and 150 cm (59.1 inch), with two distal shaft configurations achieved through distal shaft lengths of 6 cm (XT-27 model) and 18 cm (XT-27 Flex model). Both straight tip and Pre-Shaped versions are available.

Accessories: Each Excelsior XT-27 Microcatheter is provided with accessories (a shaping mandrel, and peel away introducer) within a separate inner Tyvek™ pouch (Accessory pouch). The Excelsior XT-27 Microcatheter is available in a single pack (one unit per package) only. The device pouch and Directions for Use (DFU) are both provided inside a shelf carton.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

neurovasculature

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

Bench Test Summary:

  • Visual Inspection: Durable Hydrophilic Coating, Surface Defects, Surface-Extraneous matter - Met same criteria as predicate
  • Dimensional Measurement: Kink Radius of Curvature / Proximal Shaft Kink, Distal OD Reduction, Tip Configuration, Catheter Hub - Met same criteria as predicate
  • Corrosion Resistance - Met same criteria as predicate
  • Simulated use: Introduction, Tracking, Reposition / Deployment, Detachment, Overall Performance - Met same criteria as predicate
  • Advancement / Retraction Force - Met same criteria as predicate
  • In-vitro Cytotoxicity, MEM Elution - Non-cytotoxic
  • Intracutaneous reactivity - Non-irritating
  • Acute systemic toxicity, Injection - Non-toxic
  • Sensitization, Guinea Pig Maximization - Non- sensitizing
  • Hemocompatibility, Direct Contact; Complement Activation C3a and SC5b-9; PTT; blood cell counts and hemoglobin / hematocrit levels - Non-hemolytic
  • Materials Mediated Pyrogen levels, Rabbit test - Non-pyrogenic
  • USP impurities, - None
  • Latex test, ELISA Inhibition - None

Key Metrics

Not Found

Predicate Device(s)

K000177, Renegade™ Hi-Flo™ Microcatheter, K042568, Excelsior® SL-10 Pre-Shaped Microcatheter

Reference Device(s)

Not Found

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

APR 2 0 2012

Stryker Neurovascular Traditional 510(k) Submission Excelsior® XT-27™ Microcatheter

i

. '•

K113778

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

.

Trade Name:Excelsior® XT-27™ Microcatheter
Generic Name:Percutaneous Catheter, Microcatheter
Classification:CLASS II, 21 CFR 870.1250
Submitted By:Stryker Neurovascular
47900 Bayside Parkway
Fremont, CA 94538-6515
Contact:Yoko Y Enrile
Predicate Device:K000177, Renegade™ Hi-Flo™ Microcatheter
K042568, Excelsior® SL-10 Pre-Shaped Microcatheter

Indications for Use: The Excelsior XT-27 Microcatheter is intended to assist in the delivery of
diagnostic agents (such as contrast media), therapeutic agents, and non-
liquid interventional devices (such as stents) that are indicated for use in
the neurovasculature and with a catheter of 0.027 inches in inner diameter.

Device Description: The Excelsior® XT-27™ Microcatheter is a sterile, single lumen 0.027 in
ID device with one tip marker designed to aid the physician in accessing
distal vasculature when used with a guide catheter and steerable
guidewire. Graded shaft stiffness ranging from a highly flexible tip to a
semi-rigid proximal section aids the physician in tracking over selectively
placed guidewires. A luer fitting located on the microcatheter hub is used
for the attachment of accessories. One radiopaque tip marker is positioned
at the distal tip of the device to facilitate fluoroscopic visualization. The
Excelsior XT-27 Microcatheter is coated on the outer surface with
Hydrolene™ coating which reduces friction during manipulation in the
vessel.

The Excelsior XT-27 Microcatheters are available in effective lengths of
both 135cm (53.1 inch) and 150 cm (59.1 inch), with two distal shaft
configurations achieved through distal shaft lengths of 6 cm (XT-27
model) and 18 cm (XT-27 Flex model). Both straight tip and Pre-Shaped
versions are available.

1

Accessories: Each Excelsior XT-27 Microcatheter is provided with accessories (a shaping mandrel, and peel away introducer) within a separate inner Tyvek™ pouch (Accessory pouch). The Excelsior XT-27 Microcatheter is available in a single pack (one unit per package) only. The device pouch and Directions for Use (DFU) are both provided inside a shelf carton.

Summary Differences in Technological Characteristics: The Excelsior XT-27 Microcatheters introduce several enhanced design features:

  • a) The OD profile of the Excelsior XT-27 Microcatheter is smaller than the Renegade Hi-Flo Microcatheter.
  • b) The Excelsior XT-27 Microcatheter has up to five zones of polymer stiffness which vary from the distal to proximal shaft and help to enhance the trackability and pushability of the catheter.
  • c) The Excelsior XT-27 Microcatheter has a more supportive double helix winding reinforcement compared to the Renegade Hi-Flo Microcatheter.

Bench Test Summary:

TestResult
Visual Inspection:
Durable Hydrophilic Coating
Surface Defects
Surface-Extraneous matterMet same criteria as
predicate
Dimensional Measurement:
Kink Radius of Curvature / Proximal
Shaft Kink
Distal OD Reduction
Tip Configuration
Catheter HubMet same criteria as
predicate
Corrosion ResistanceMet same criteria as
predicate

2

. . . . . .

and the control of the county of

.

.

:

:

.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.

:

:

.

:

:

Simulated use:Met same criteria as predicate
* Introduction
* Tracking
* Reposition / Deployment
* Detachment
* Overall Performance
Advancement / Retraction ForceMet same criteria as predicate
In-vitro Cytotoxicity, MEM ElutionNon-cytotoxic
Intracutaneous reactivityNon-irritating
Acute systemic toxicity, InjectionNon-toxic
Sensitization, Guinea Pig
MaximizationNon- sensitizing
Hemocompatibility, Direct Contact;
Complement Activation C3a and
SC5b-9; PTT; blood cell counts and
hemoglobin / hematocrit levelsNon-hemolytic
Materials Mediated Pyrogen levels,
Rabbit testNon-pyrogenic
USP impurities,None
Latex test, ELISA InhibitionNone

·

:

3

Predicate / SubjectProduct Feature Comparison for Excelsior® SL-10 Pre-Shaped
DeviceMicrocatheter (K042568) and Renegade™ Hi-Flo™ Microcatheter
(K000177)
Comparison:(K000177)

| Feature | K042568
Excelsior® SL-10
Pre-Shaped
Microcatheter | K000177
Renegade™ Hi-Flo™
Microcatheter | Subject Device |
|----------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|
| Materials | PTFE, Pebax,
Stainless Steel
wire, Nylon,
Santoprene | PTFE, Pebax,
Vectran Fiber and
Pt/Ir wire, Nylon,
Santoprene | PTFE, Pebax,
Stainless Steel
wire, Nylon,
Santoprene |
| Tip shape | Preshaped | Straight | Offers both shapes
(Straight and
Preshaped) |
| | Option of steam
shaping by
physician for
proper adjustment
to the anatomy
prior to use | Option of steam
shaping by
physician for
proper adjustment
to the anatomy
prior to use | Option of steam
shaping by
physician for
proper adjustment
to the anatomy
prior to use |
| Effective
Lengths | 150 cm | 135 cm, 150 cm | 135 cm, 150 cm |
| Proximal
/Distal OD | Proximal OD 2.4F
Distal OD 1.7F | Proximal OD 3F
Distal OD 2.8F | Proximal OD: 2.9F
Distal OD: 2.7F |
| ID | 0.0165 inch | 0.027inch | 0.027inch |
| Hydrophilic
Coating
Length | 100 cm | 60 cm | 80 cm |
| Tip Length | 6cm | 10cm and 20cm | 6cm and 18cm |
| Tip Markers | 90%Pt-10%Ir | 90%Pt-10%Ir | 90%Pt-10%Ir |
| Coating | Polyvinylpyrrolidone Polyacrylamide | Hydropass
Hydrophilic
Coating | Polyvinylpyrrolidone Polyacrylamide |
| Method of
supply | Sterile, single-use,
non-pyrogenic | Sterile, single-use,
non-pyrogenic | Sterile, single-use,
non-pyrogenic |

Summary of Substantial Equivalence: The Excelsior XT-27 Microcatheter subject of this submission is substantially equivalent to the predicate devices with regard to design, materials, sterilization, principle of operation, performance, and indications for use.

4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three tail feathers, representing the department's commitment to promoting health, well-being, and human services. The eagle is positioned within a circle, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged around the upper portion of the circle.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Stryker Neurovascular c/o Ms. Tina Lochner DEKRA Certification. Inc. 4377 County Line Road Chalfont, PA 18914

APR 2 0 2012

Re: K113778

Trade/Device Name: Excelsior XT-27 Microcatheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: DQY, KRA Dated: March 16, 2012 Received: March 22, 2012

Dear Ms. Lochner:

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 r ou may, thereforey issues of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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

5

Page 2 - Ms. Tina Lochner

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 (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH0ffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. 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 go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely vours.

Ea. Hemm

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

Enclosure

6

Indications for Use

510(k) Number (if known): K113778

Device Name: . . . . . _ _ _ Excelsior® XT-27™ Microcatheter

Indications For Use:

The Excelsior XT-27 Microcatheter is intended to assist in the delivery of diagnostic agents (such as contrast media), therapeutic agents, and non-liquid interventional devices (such as stents) that are indicated for use in the neurovasculature and with a catheter of 0.027 inches in inner diameter.

Prescription Use × (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)

Quyuh Hoang
(Division Sign-Off)

Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices

510(k) Number_

K113778

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