K Number
K120164
Device Name
PROTEUS PTA BALLOON CATHETER WITH EMBOLIC CAPTURE FEATURE
Manufacturer
Date Cleared
2012-06-08

(141 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Angioslide PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is indicated for peripheral transluminal angioplasty and for capture and containment of embolic material during angioplasty, for the femoral, iliac, ilio-femoral, popliteal, tibial, peroneal, and profunda arteries. The Angioslide PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature is not intended for use in the renal, cerebral, coronary or carotid vasculature.
Device Description
The Angioslide PROTEUSTM Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is an over the wire dual lumen catheter with a foldable balloon (5) located near the distal atraumatic soft tip (9). One lumen is used for inflation of the balloon and is accessed via the inflation port (2). The other lumen, starting at the guidewire port (10), allows access to the distal tip for guidewire insertion (max. 0.035"). The balloon has two radiopaque markers (8) for positioning the balloon relative to stenosis. The radiopaque markers indicate the dilating section of the balloon and help in balloon placement. The balloon is designed to provide an inflatable segment of known diameter and length at specified pressure. The shaft (4) comprises the outer shaft (6) and the inner shaft (7). The distal end of the balloon (A) is connected to the inner shaft and the proximal end of the balloon (B) is connected to the outer shaft. The inner shaft is connected to the proximal hub (10) which is connected to the pulling knob (1) and the outer shaft is connected to the handle grip (3). The pulling knob lock (11) locks the handle grip and the pulling knob together. The distal end of the balloon is folded inwards towards the proximal end of the balloon, by pressing on pulling knob lock ( 1 l ) and pulling the pulling knob away from the handle (1). The embolic capture feature involves a single-use suction mechanism that works through inward folding of the balloon, which creates negative pressure within the capture cavity for debris capture and removal. The reduced pressure in the capture cavity causes some of the particles that are released during the procedure to flow into the cavity for containment and removal. The balloon size and diameter are printed on the strain relief (12). Refer also to the package label for information about catheter length, balloon nominal and rated burst pressure, balloon size, balloon compliance, guidewire compatibility and sheath compatibility.
More Information

Not Found

No
The device description and performance studies focus on mechanical and hydraulic principles (balloon inflation, folding, negative pressure) and do not mention any computational or data-driven components indicative of AI/ML. The "Mentions AI, DNN, or ML" field is also explicitly marked as "Not Found".

Yes.
The device is used for peripheral transluminal angioplasty and for capture and containment of embolic material, which are therapeutic procedures.

No

The device is a therapeutic device used for percutaneous transluminal angioplasty and embolic capture, not for diagnosing conditions.

No

The device description clearly details a physical catheter with a balloon, lumens, ports, and a mechanical embolic capture feature. There is no mention of software as the primary or sole component of the device.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description and Intended Use: The description clearly states that the Angioslide PROTEUS™ is a catheter with a balloon and embolic capture feature used for peripheral transluminal angioplasty in specific arteries. This is a procedure performed within the body to open narrowed blood vessels and capture debris.
  • Lack of Specimen Analysis: There is no mention of the device being used to analyze any biological specimens taken from the patient.

The device is an invasive medical device used for a therapeutic procedure, not an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

The PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is indicated for peripheral transluminal angioplasty and for capture and containment of embolic material during angioplasty, for the femoral, iliac, illo-femoral, poplited, tibial, peroneal, and profunda arteries.

The PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature is not intended for use in the renal, cerebral, coronary or carotid vasculature.

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

DQY, LIT

Device Description

The Angioslide PROTEUSTM Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is an over the wire dual lumen catheter with a foldable balloon (5) located near the distal atraumatic soft tip (9).

One lumen is used for inflation of the balloon and is accessed via the inflation port (2). The other lumen, starting at the guidewire port (10), allows access to the distal tip for guidewire insertion (max. 0.035"). The balloon has two radiopaque markers (8) for positioning the balloon relative to stenosis. The radiopaque markers indicate the dilating section of the balloon and help in balloon placement. The balloon is designed to provide an inflatable segment of known diameter and length at specified pressure.

The shaft (4) comprises the outer shaft (6) and the inner shaft (7). The distal end of the balloon (A) is connected to the inner shaft and the proximal end of the balloon (B) is connected to the outer shaft. The inner shaft is connected to the proximal hub (10) which is connected to the pulling knob (1) and the outer shaft is connected to the handle grip (3). The pulling knob lock (11) locks the handle grip and the pulling knob together. The distal end of the balloon is folded inwards towards the proximal end of the balloon, by pressing on pulling knob lock ( 1 l ) and pulling the pulling knob away from the handle (1). The embolic capture feature involves a single-use suction mechanism that works through inward folding of the balloon, which creates negative pressure within the capture cavity for debris capture and removal. The reduced pressure in the capture cavity causes some of the particles that are released during the procedure to flow into the cavity for containment and removal.

The balloon size and diameter are printed on the strain relief (12). Refer also to the package label for information about catheter length, balloon nominal and rated burst pressure, balloon size, balloon compliance, guidewire compatibility and sheath compatibility.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

femoral, iliac, illo-femoral, poplited, tibial, peroneal, and profunda arteries

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 verification and validation of the PROTEUS™ PTA Balloon Catheter was performed through extensive bench testing, sterilization, packaging and shelf life testing. Design verification and validation testing of the PROTEUSTM PTA Balloon Catheter was performed using a "four corners" approach (i.e. 2 x 2 factorial of the largest and smallest balloon diameters and lengths. In addition to these four sizes, a middle catheter size was tested to provide supplemental data to support the robustness of the overall design of the Angioslide PROTEUSTM PTA Balloon Catheter. Sample sizes used for Design Verification and Validation testing were based on required confidence/reliability levels as a result of risk analysis performed for the PROTEUS™ PTA Balloon Catheter, or per recommendations within the FDA Guidance "Non-Clinical Tests and Recommended Labeling for Intravascular Stents and Associated Delivery Systems." Specifically, the number of samples utilized for each test depended on whether the data to be collected was variable data or attribute data in nature.

All tests passed: Visual Inspection - External Surface, Visual Inspection - Distal Tip, Dimensional Inspection - Distal Bond O.D., Dimensional Inspection - Soft Tip Length, Dimensional Inspection - Guidewire Inner Lumen, Dimensional Inspection - Wrapped Balloon O.D., Dimensional Inspection - Catheter Overall Length, Dimensional Inspection - Catheter Overall Effective Length, Dimensional Inspection - Knob Height, Handle Assembly Burst, Handle Assembly Fatigue, Handle Assembly Leakage, Balloon Inflation and Deflation Time, Tensile Strength - Distal Balloon to Inner Shaft (Peel), Tensile Strength - Distal Balloon to Inner Shaft (Shear), Tensile Strength - Outer Shaft to T Connector, Tensile Strength - Inflation Tube to T Connector, Tensile Strength – Inflation Tube to Inflation Luer, Tensile Strength - Cylinder to T Connector, Tensile Strength - Inner Shaft to Pulling Rod, Tensile Strength - Pulling Rod to Proximal Luer, Tensile Strength - Pulling Rod to Knob Base, Tensile Strength - Distal Cap to Shells, Tensile Strength - Proximal Cap to Shells, Tensile Strength - Knob Base to Knob Cover, Corrosion Resistance, Stroke Length, Simulated Use in Tortuous Anatomy Model - guidewire compatibility, Simulated Use in Tortuous Anatomy Model - Advance/Retract/Deploy/Fold Balloon/Withdraw after Procedure, Simulated Use in Tortuous Anatomy Model - Kink Resistance, Flow Characteristics, Labeling Validation, Packaging Validation - Pouch Label Visual Inspection, Packaging Validation - Pouch Seal Visual Inspection, Packaging Validation - Bubble Leak Testing, Packaging Validation - Seal Strength Testing.

Results of the testing demonstrated that the PROTEUS™ PTA Balloon Catheter design met all specifications and is adequate for its intended use.

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.

K111750

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

§ 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

K120164

JUN - 8 2012

510(k) Summary

PROTEUS™ PTA Catheter with Embolic Capture Feature

Introduction

This document contains the 510(k) summary for the modified PROTEUS™ PTA Catheter with Embolic Capture Feature. The content of this summary is based on the requirements of 21 CFR Section 807.92(c).

Applicant Name and Address:

Name:Angioslide, Ltd.
Address:7 Halamish St.
Business and Industry Park - North
Caesarea 30889
Israel
Tel: 011-972-4-6187200
Fax: 011-972-4-6187222
Official Contact:Clay Anselmo
CEO
Reglera LLC
Address:11925 W. I-70 Frontage Rd. North
Suite 900
Wheat Ridge, CO 80033
Phone:303-223-4303
Fax:303-832-6700
E-mail:anselmoc@reglera.com

Summary Preparation Date: 1/18/2012

Device Name and Classification:

| Trade Name: | PROTEUS™ PTA Balloon Catheter with
Embolic Capture Feature |
|----------------------|---------------------------------------------------------------|
| Common Name: | Percutaneous Transluminal Angioplasty
Balloon Catheter |
| Classification Name: | Catheter, Percutaneous |
| Classification: | Class II, 21 CFR 870.1250 |
| Product Code | DQY/LIT |

1

Predicate Devices:

The modified PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is claimed to be substantially equivalent to the following legally marketed predicate device:

  • Angioslide PROTEUSTM PTA Balloon Catheter with Embolic Capture Feature . (K111750)
    Performance Standards: There are no mandatory performance standards for this device.

Device Description (see Figure 1)

Image /page/1/Figure/6 description: This image shows a diagram of a medical device with labeled parts. The device includes a handle (3), a needle (4, 5), and a connector (2). Detail A shows a close-up of the needle tip (9), while Detail B shows the needle base (6). Other labeled components include 1, 7, 8, 10, 11, and 12.

Figure 1

The Angioslide PROTEUSTM Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is an over the wire dual lumen catheter with a foldable balloon (5) located near the distal atraumatic soft tip (9).

One lumen is used for inflation of the balloon and is accessed via the inflation port (2). The other lumen, starting at the guidewire port (10), allows access to the distal tip for guidewire insertion (max. 0.035"). The balloon has two radiopaque markers (8) for positioning the balloon relative to stenosis. The radiopaque markers indicate the dilating section of the balloon and help in balloon placement. The balloon is designed to provide an inflatable segment of known diameter and length at specified pressure.

2

The shaft (4) comprises the outer shaft (6) and the inner shaft (7). The distal end of the balloon (A) is connected to the inner shaft and the proximal end of the balloon (B) is connected to the outer shaft. The inner shaft is connected to the proximal hub (10) which is connected to the pulling knob (1) and the outer shaft is connected to the handle grip (3). The pulling knob lock (11) locks the handle grip and the pulling knob together. The distal end of the balloon is folded inwards towards the proximal end of the balloon, by pressing on pulling knob lock ( 1 l ) and pulling the pulling knob away from the handle (1). The embolic capture feature involves a single-use suction mechanism that works through inward folding of the balloon, which creates negative pressure within the capture cavity for debris capture and removal. The reduced pressure in the capture cavity causes some of the particles that are released during the procedure to flow into the cavity for containment and removal.

The balloon size and diameter are printed on the strain relief (12). Refer also to the package label for information about catheter length, balloon nominal and rated burst pressure, balloon size, balloon compliance, guidewire compatibility and sheath compatibility.

Indications for Use:

The PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is indicated for peripheral transluminal angioplasty and for capture and containment of embolic material during angioplasty, for the femoral, iliac, illo-femoral, poplited, tibial, peroneal, and profunda arteries.

The PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature is not intended for use in the renal, cerebral, coronary or carotid vasculature.

Comparison of Technological Characteristics

The PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter is an over the wire co-axial dual lumen catheter with a foldable balloon located near the distal atraumatic soft tip. The catheter is compatible with a 0.035" guidewire.

The balloon catheter technological characteristics of the PROTEUS™ PTA Balloon Catheter are identical to those of the PROTEUS™ PTA Balloon Catheter (K111750). In both devices, lesion dilation is achieved by means of an inflatable balloon.

The PROTEUS™ PTA Balloon Catheter overall length, catheter sheath sizing, balloon diameter, balloon length, balloon nominal pressure, balloon rated burst pressure and end hole diameter are the same as those of the PROTEUS™ PTA Balloon Catheter (K111750).

The embolic capture technological characteristics of the PROTEUS™ PTA Balloon Catheter are identical to those of the PROTEUS™ PTA Balloon Catheter (K111750). In both devices, the containment and removal of embolic material is achieved by proximal vessel occlusion, by means of an inflatable balloon, and subsequent capture and removal of embolic material.

Summary of Non-Clinical Testing

3

In vitro bench testing of the Angioslide PROTEUS™ PTA Balloon Catheter was conducted in accordance with Angioslide's Risk Analysis and all applicable FDA Guidance documents and ISO standards, including:

ISO 10555-1 - Sterile, Single Use Intravascular Catheters- Part 1: General Requirements

ISO 10555-4 - Sterile, Single Use Intravascular Catheters- Part 4: Balloon Dilatation Catheters

FDA Guidance - Non-Clinical Tests and Recommended Labeling for Intravascular Stents and Associated Delivery Systems , January 13, 2005

FDA Guidance - Coronary and Carotid Embolic Protection Devices - Premarket Notification [510(k)] Submissions, February 15, 2008

All bench testing, unless otherwise specified, was conducted using finished devices which were sterilized by the final validated sterilization process.

Design Verification and Validation:

Design verification and validation testing of the PROTEUSTM PTA Balloon Catheter was performed using a "four corners" approach (i.e. 2 x 2 factorial of the largest and smallest balloon diameters and lengths. In addition to these four sizes, a middle catheter size was tested to provide supplemental data to support the robustness of the overall design of the Angioslide PROTEUSTM PTA Balloon Catheter. Sample sizes used for Design Verification and Validation testing were based on required confidence/reliability levels as a result of risk analysis performed for the PROTEUS™ PTA Balloon Catheter, or per recommendations within the FDA Guidance "Non-Clinical Tests and Recommended Labeling for Intravascular Stents and Associated Delivery Systems." Specifically, the number of samples utilized for each test depended on whether the data to be collected was variable data or attribute data in nature.

4

Test DescriptionAccept/Reject CriteriaResults
Visual Inspection -
External SurfaceExternal surface of catheter effective
length, including the distal end, is free
from extraneous matter and surface
defects
90% Confidence, 90% ReliabilityPASS
Visual Inspection -
Distal TipDistal tip is smooth, rounded, tapered, or
similarly finished.
90% Confidence, 90% ReliabilityPASS
Dimensional
Inspection - Distal
Bond O.D.In Tolerance
90% Confidence, 90% ReliabilityPASS
Dimensional
Inspection - Soft
Tip LengthIn Tolerance
90% Confidence, 90% ReliabilityPASS
Dimensional
Inspection -
Guidewire Inner
LumenIn Tolerance
90% Confidence, 90% ReliabilityPASS
Dimensional
Inspection -
Wrapped Balloon
O.D.The balloon must pass aperture Bacterial Endotoxins Test

9

Shelf Life:

The PROTEUS™ PTA Balloon Catheter is currently validated for a three (3) year shelf life. After sterilization and accelerated aging, device function and performance verification/validation testing was conducted on the PROTEUS™ PTA Balloon Catheter and its packaging system that included the following:

  • Device
    • Visual Inspection o
    • Dimensional Inspection
    • Balloon Burst Pressure Testing 0
    • Balloon Fatigue Testing O
    • Balloon Compliance Testing 0
    • Balloon Inflation/Deflation Testing o
    • Catheter Leakage Testing O
    • Bond Tensile Strength Testing o
    • Simulated Use Testing 0
    • Stroke Length Testing o
    • Flow Characteristics Testing o
    • o Corrosion Resistance Testing

Packaging .

  • O Visual Inspection (per ASTM F1886)
  • o Leak Testing (per ASTM F2096/ASTM F1929)
  • o Pouch Seal Strength Testing (per ASTM F88)

The results of the testing described above were found to meet all acceptance criteria, and demonstrate that the PROTEUS™ PTA Balloon Catheter and its packaging system meets all functional and performance specifications at the product's three year shelf-life. Accelerated aging results are being confirmed through real time aging studies.

Substantial Equivalence Conclusion:

Non-clinical verification and validation of the PROTEUS™ PTA Balloon Catheter was performed through extensive bench testing, sterilization, packaging and shelf life testing. Results of the testing demonstrated that the PROTEUS™ PTA Balloon Catheter design met all specifications and is adequate for its intended use. Additionally, the test results demonstrated substantial equivalence of the PROTEUS™ PTA Balloon Catheter to its predicate device.

In conclusion, the PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature is substantially equivalent in intended use, technological characteristics, safety, and performance characteristics to the following legally marketed predicate device:

  • PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature, Angioslide -K11750

10

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/10/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and features an eagle with its wings spread. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are written around the eagle in a circular fashion. The seal is black and white.

Public Health Service

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

JUN - 8 2012

Angioslide c/o Clay Anselmo CEO Reglera, LLC 11925 West I-70 Frontage Road North Suite 900 Wheat Ridge, CO 80033

Re: K120164

Trade/Device Name: PROTEUS PTA Balloon Catheter with Embolic Capture Feature Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: LIT, DQY Dated: May 11, 2012 Received: May 14, 2012

Dear Mr. Anselmo:

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 note: CDRH does not evaluate information related to contract liability warranties. However, we remind you 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 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.

11

Page 2 - Mr. Clay Anselmo

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 of medical devicerelated 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.

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/CDRH/CDRHOffices/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 yours,

M.S. Killebrew

Bram Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

12

Indications for Use

510(k) Number (if known): 上(ac) 164

Device Name: PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature

Indications for Use:

The Angioslide PROTEUS™ Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter with Embolic Capture Feature is indicated for peripheral transluminal angioplasty and for capture and containment of embolic material during angioplasty, for the femoral, iliac, ilio-femoral, popliteal, tibial, peroneal, and profunda arteries.

The Angioslide PROTEUS™ PTA Balloon Catheter with Embolic Capture Feature is not intended for use in the renal, cerebral, coronary or carotid 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)

Miz Keller

Page 1 of 1

(Division Sign-Off) Division of Cardiovascular Devices

K120164 510(k) Number_