K Number
K153729
Device Name
8F FlowGate2 Balloon Guide Catheter
Manufacturer
Date Cleared
2016-01-27

(30 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Flow Gate Balloon Guide Catheters are indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. The balloon provides temporary vascular occlusion during these and other angiographic procedures. The Balloon Guide Catheter is also indicated for use as a conduit for Retrieval devices.
Device Description
Like the predicate device, the 8F FlowGate2™ Balloon Guide Catheter is a coaxial- lumen, braidreinforced, variable stiffness catheter designed for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. A radiopaque marker is included on the distal end for angiographic visualization. A compliant balloon is mounted on the distal end to provide temporary vascular occlusion during angiographic procedures. A bifurcated luer hub on the proximal end allows attachments for flushing, inflation and aspiration. Modified FlowGate™ Balloon Guide Catheter dimensions and maximum recommended balloon inflation volume are indicated on product label.
More Information

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

No.
The device facilitates the insertion and guidance of other catheters; it is not directly listed as providing therapeutic intervention itself, but rather as an accessory to procedures.

No

Explanation: The device is a guide catheter used to facilitate the insertion and guidance of other intravascular catheters and provide temporary vascular occlusion. Its function is interventional, not diagnostic.

No

The device description clearly details a physical catheter with a balloon, radiopaque marker, and luer hub, indicating it is a hardware device, not software-only.

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 (like blood, urine, or tissue) taken from the human body to provide information about a person's health. This testing is done outside of the body (in vitro).
  • Device Function: The description clearly states that the Flow Gate Balloon Guide Catheter is used within the body (in vivo) to facilitate the insertion and guidance of other catheters and provide temporary vascular occlusion during angiographic procedures. It is a tool used during a medical procedure, not a device for analyzing biological samples.

The device is an invasive medical device used for interventional procedures.

N/A

Intended Use / Indications for Use

Flow Gate Balloon Guide Catheters are indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. The balloon provides temporary vascular occlusion during these and other angiographic procedures. The Balloon Guide Catheter is also indicated for use as a conduit for Retrieval devices.

Product codes

DQY

Device Description

Like the predicate device, the 8F FlowGate2™ Balloon Guide Catheter is a coaxial-lumen, braidreinforced, variable stiffness catheter designed for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. A radiopaque marker is included on the distal end for angiographic visualization. A compliant balloon is mounted on the distal end to provide temporary vascular occlusion during angiographic procedures. A bifurcated luer hub on the proximal end allows attachments for flushing, inflation and aspiration. Modified FlowGate™ Balloon Guide Catheter dimensions and maximum recommended balloon inflation volume are indicated on product label.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Peripheral and neuro vasculature

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)

The results of verification and validation testing conducted on the subject device demonstrate that it performs as designed, and is suitable for its intended use. Specifically, the following tests were performed on the subject device:
Test: Modifications to catheter shaft
Catheter Simulated Use (Retriever/Microcatheter Compatibility): Met established acceptance criteria.
Catheter Kink Resistance, Variables (Test Kink Resistance): Met established acceptance criteria.
Catheter Tip Flexibility (Catheter/Vessel Interaction): Met established acceptance criteria.
Torque Transmission: Met established acceptance criteria.
High Pressure Leak: Met established acceptance criteria.
Test: 6F Dilator Accessory
Dimensional Verification: Met established acceptance criteria.
Dilator Shape Retention: Met established acceptance criteria.
Air Leak Resistance: Met established acceptance criteria.
Liquid Leak Resistance: Met established acceptance criteria.
Tensile Strength: Met established acceptance criteria.
High Pressure Leak: Met established acceptance criteria.
Catheter/Vessel Interaction (Catheter Tip Flexibility): Met established acceptance criteria.
Kink Resistance: Met established acceptance criteria.
Distal Shaft Trackability: Met established acceptance criteria.
Lumen Compatibility: Met established acceptance criteria.
Test: Tuohy Borst Valve with Sideport Accessory
Hub Gauging: Met established acceptance criteria.
Liquid leakage: Met established acceptance criteria.
Air Leakage: Met established acceptance criteria.
Separation Force: Met established acceptance criteria.
Unscrewing Torque: Met established acceptance criteria.
Ease of Assembly: Met established acceptance criteria.
Resistance to Overriding: Met established acceptance criteria.
Stress Cracking: Met established acceptance criteria.
Catheter Simulated Use (Tuohy Borst Valve with Sideport seal over devices and wires): Met established acceptance criteria.

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

Not Found

Predicate Device(s)

K131492

Reference Device(s)

K122581

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

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles a stylized caduceus, with three figures in profile facing right.

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

January 27,2016

Concentric Medical, Inc. Mr. Shazia Hakim Senior Regulatory Affairs Specialist 301 East Evelyn Avenue Mountain View, California 94041

Re: K153729

Trade/Device Name: 8F FlowGate Balloon Guide Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: DQY Dated: December 22, 2015 Received: December 28, 2015

Dear Mr. Hakim:

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. 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 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.

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 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.

1

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

William J. Heetderks -S

for

Carlos L. Peña, PhD, MS Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K153729

Device Name 8F FlowGate Balloon Guide Catheter

Indications for Use (Describe)

Flow Gate Balloon Guide Catheters are indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. The balloon provides temporary vascular occlusion during these and other angiographic procedures. The Balloon Guide Catheter is also indicated for use as a conduit for Retrieval devices.

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

Device Trade Name:8F FlowGate2™ Balloon Guide Catheter
Common Name:Percutaneous Catheter
Classification Name:Percutaneous Catheter, 21CFR 870.1250 Class II
Product Code:DQY
Submitter:Concentric Medical, Inc.
301 E. Evelyn Avenue
Mountain View, CA 94041
Tel 510 - 413-2636
Fax 510 - 413-2588
Facility Registration #2954917
Contact:Shazia Hakim
Senior Regulatory Affairs Specialist

Date Prepared: December 22, 2015

Predicate Device:

Primary Predicate Device
K131492
(clearance granted
October 3, 2013)Modified FlowGate™ Balloon
Guide Catheter
Reference Predicate Device
K122581
(clearance granted
November 21, 2012)Concentric Balloon Guide
Catheter

4

Device Description

Like the predicate device, the 8F FlowGate2™ Balloon Guide Catheter is a coaxial- lumen, braidreinforced, variable stiffness catheter designed for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. A radiopaque marker is included on the distal end for angiographic visualization. A compliant balloon is mounted on the distal end to provide temporary vascular occlusion during angiographic procedures. A bifurcated luer hub on the proximal end allows attachments for flushing, inflation and aspiration. Modified FlowGate™ Balloon Guide Catheter dimensions and maximum recommended balloon inflation volume are indicated on product label.

Accessories

The 8F FlowGate2™ Balloon Guide Catheter is packaged with a Dilator, Rotating Hemostasis Valve, Tuohy Borst Valve with Sideport, Peel Away Sheaths, Luer-Activated Valve, and Extension tubing.

Indications for Use

The Indications for Use are the same as the predicate devices and are as follows:

FlowGate" Balloon Guide Catheters are indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. The balloon provides temporary vascular occlusion during these and other angiographic procedures. The Balloon Guide Catheter is also indicated for use as a conduit for Retrieval devices.

Technological Characteristics and Product Feature Comparison

The subject device, 8F FlowGate2™ Balloon Guide Catheter is substantially equivalent to the predicate devices in terms of:

  • indications for use
  • fundamental scientific technology
  • fundamental design
  • materials and processes for packaging and sterilization of devices

A tabular comparison of the specific technological characteristics between the predicate devices and subject device is provided below.

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Product Feature Comparison of Subject Device with Predicate Devices (K122581, K131492)
FeatureReference Predicate Device (K122581)Primary Predicate Device (K131492)Subject DeviceRationale for difference (if applicable)
Indications for UseThe Concentric Balloon Guide Catheter is indicated for use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel in the peripheral and neuro vascular systems. The balloon provides temporary vascular occlusion during these and other angiographic procedures. The Balloon Guide Catheter is also indicated for use as a conduit for Retrieval devices.Same except for product name as “FlowGate Balloon Guide Catheter”Same as predicate device (K131492)Not applicable
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Device DescriptionThe Concentric Balloon
Guide Catheters are
coaxial-lumen, braid-
reinforced, variable
stiffness catheters designed
for use in facilitating the
insertion and guidance of
an intravascular catheter
into a selected blood vessel
in the peripheral and neuro
vascular systems. A
radiopaque marker is
included on the distal end
for angiographic
visualization. A compliant
balloon is mounted on the
distal end to provide
temporary vascular
occlusion during
angiographic procedures. A
bifurcated luer hub on the
proximal end allows
attachments for flushing,
inflation and aspiration.
Balloon Guide Catheter
dimensions and maximum
recommended balloon
inflation volume are
indicated on product label.Same except for
product name as
"FlowGate
Balloon Guide
Catheter"Same as
predicate device
(K131492)Not applicable
Target PopulationPatients undergoing
percutaneous
interventional proceduresSameSameNot applicable
Anatomical SitesPeripheral and neuro
vasculatureSameSameNot applicable
Regulatory Status
Regulation Number21CFR 870.1250SameSameNot applicable
Regulation NamePercutaneous CatheterSameSameNot applicable
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Regulatory ClassIISameSameNot applicable
Product CodeDQYSameSameNot applicable
Materials
Outer Jacket-
Proximal ShaftPurple Pebax® 7233
Barium sulfateSameSameNot applicable
Outer Jacket- Distal
ShaftBlue Pebax 6333
Barium sulfateSameSameNot applicable
Inner Jacket-
Proximal ShaftWhite Polyamide Blend
Barium sulfateSameSameNot applicable
Inner Jacket -
Proximal TransitionNatural Pebax 7233
Barium sulfateSameSameNot applicable
Inner Jacket -
Proximal Mid ShaftNatural Pebax 5533,
Barium sulfateSameSameNot applicable
Inner Jacket -
Distal Mid ShaftNatural Pebax 4033SameSameNot applicable
Inner Jacket -
Distal ShaftWhite Pebax 2533,
Barium sulfateSameSameNot applicable
Distal TipWhite Pebax 2533,
Barium sulfateWhite Pebax
3533
White Pebax
2533
Barium sulfateSame as
predicate device
(K131492)Not applicable
Balloon MaterialNuSil MED 4035 silicone
elastomerNuSil MED 4025
silicone
elastomerSame as
predicate device
(K131492)Not applicable
Balloon Bond
AdhesiveLoctite 4011 Cyanoacrylate
Loctite 3974 UV AdhesiveSameSameNot applicable
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Braid304V Stainless SteelSameSameNot applicable
Braid distal end
securementLoctite UV AdhesiveLoctite 4014
CyanoacrylateSame as
predicate device
(K131492)Not applicable
LinerEtched PTFESameSameNot applicable
Marker Band90% Platinum/10% IridiumSameSameNot applicable
Luer Hub AdhesiveLoctite 3321 UV AdhesiveSameSameNot applicable
2-Arm Luer HubPolyurethaneSameSameNot applicable
Strain ReliefWhite Pebax 4033
White PolyolefinWhite Pebax
4033
White PolyolefinSame as
predicate device
(K131492)Not applicable
Labeled Shaft
Outer Diameter8F (2.7mm)SameSameNot applicable
Labeled Shaft Inner
Diameter6.4F (0.084 inch /2.1 mm)SameSameNot applicable
Maximum outer
diameter along
effective length0.108 inchSameSameNot applicable
Effective Lengths100 cm and 90 cm95 cm and 85 cmSame as
predicate device
(K131492)Not applicable
Radiopaque
Marker Location
from Distal Tip2 mm0.75 mmSame as
predicate device
(K131492)Not applicable
Radiopaque
Marker Length0.020 inchSameSameNot applicable
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Accessory Devices
ProvidedDilator (1)
Rotating Hemostasis Valve
(1)
Tuohy Borst Valve with
sideport (1)
Peel Away Sheaths (2)
Luer-Activated Valve (1)Same as
predicate
device,
with addition of
Extension
Tubing (1)Same as
predicate
device, K131492
except for
modified Dilator
tip shape and
Tuohy Borst
Valve with
Sideport with
smaller IDThe 6F Dilator
and Tuohy Borst
Valve with
Sideport have
been modified
to meet user
preferences.
Bench testing
has
demonstrated
that the
compatibility of
modified 6F
Dilator and
Tuohy Borst
Valve with
Sideport with
the subject
device does not
affect the safety
and
effectiveness of
the device.
Tuohy Borst Valve
with Sideiport
materialABS body
polypropylene cap
PVC tubing
polycarbonate luer
silicone seal
LDPE washer/ringSameSame as
predicate
device, K131492
except for
Polycarbonate
body
polycarbonate
сар
PVC tubing
polycarbonate
luer
silicone seal
PTFE
washer/ringThe Tuohy Borst
Valve with
Sideport has
been modified
to meet user
preferences.
Bench testing
has
demonstrated
that the
compatibility of
modified Tuohy
Borst Valve with
Sideport with
the subject
device does not
affect the safety
and
effectiveness of
the device.
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Dilator Shaft
materialBlue Pebax
Barium sulfate
Bismuth subcarbonate (at
tip only) Stainless Steel
braid wireSameSameNot applicable
Dilator Hub
materialWhite PolycarbonateSameSameNot applicable
Dilator Strain Relief
Sleeve materialGreen PebaxSameSameNot applicable
Dilator adhesive
materialsCyanoacrylateSameSameNot applicable
Dilator Shaft Outer
Diameter (nominal)0.072 inch (distal), 0.078
inch (proximal)SameSameNot applicable
Dilator Inner
Diameter (nominal)0.041 inch (distal), 0.050"
(proximal)SameSameNot applicable
Dilator Effective
Length (nominal)123 cmSameSameNot applicable
Dilator Distal Tip
Angle60°SameSameNot applicable
FeatureReference Predicate
Device (K122581)Primary
Predicate Device
(K131492)Subject DeviceRationale for
difference (if
applicable)
Dilator Distal Tip
Length1.40 inchSame0.67 inchesThe tip shape of
the 6F Dilator
has been
shortened to
meet user
preferences.
Bench testing
has
demonstrated
that the
compatibility of
the shorter
distal tip length
of the 6F Dilator
with the subject
device does not
affect the safety
and
effectiveness of
the device.
Packaging
Materials and
ConfigurationPolyethylene tubes for
catheter and dilator, HDPE
sterile prep card and
packaging card, Tyvek and
LLDPE/Nylon Film Pouch,
Chipboard cartonSameSameNot applicable
Sterilization
Method100% EtOSameSameNot applicable
How SuppliedSterile, Single UseSameSameNot applicable

Product Feature Comparison of Subject Device with Predicate Devices (K122581, K131492)

6

Concentric Medical, Inc.

Premarket Notification, Special 510(k) 8F FlowGate²™ Balloon Guide Catheter

7

8

9

Concentric Medical, Inc.

Premarket Notification, Special 510(k) 8F FlowGate²™ Balloon Guide Catheter

10

Concentric Medical, Inc. Premarket Notification, Special 510(k) 8F FlowGate²™ Balloon Guide Catheter

11

Concentric Medical, Inc. Premarket Notification, Special 510(k) 8F FlowGate²™ Balloon Guide Catheter

12

Risk Assessment

Risk assessment of the modifications has been conducted in accordance with EN ISO 14971:2012. Concentric Medical, Inc. has determined that the modifications to the predicate devices raise no new questions of safety or effectiveness.

Results of verification and validation testing have demonstrated the subject device is substantially equivalent to the predicate devices. Furthermore, the modifications did not result in any new failure modes nor were there any changes to existing failure modes.

Testing Summary

The results of verification and validation testing conducted on the subject device demonstrate that it performs as designed, and is suitable for its intended use. Specifically, the following tests were performed on the subject device:

TestConclusions
Modifications to catheter shaft
Catheter Simulated Use (Retriever/
Microcatheter Compatibility)Met established acceptance criteria.
Catheter Kink Resistance, Variables (Test
Kink Resistance)Met established acceptance criteria.
Catheter Tip Flexibility (Catheter/
Vessel Interaction)Met established acceptance criteria.
Torque TransmissionMet established acceptance criteria.
High Pressure LeakMet established acceptance criteria.
6F Dilator AccessoryMet established acceptance criteria.
Dimensional VerificationMet established acceptance criteria.
Dilator Shape RetentionMet established acceptance criteria.
Air Leak ResistanceMet established acceptance criteria.
Liquid Leak ResistanceMet established acceptance criteria.
Tensile StrengthMet established acceptance criteria.
High Pressure LeakMet established acceptance criteria.
Catheter/
Vessel Interaction (Catheter Tip Flexibility)Met established acceptance criteria.

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TestConclusions
Kink ResistanceMet established acceptance criteria.
Distal Shaft TrackabilityMet established acceptance criteria.
Lumen CompatibilityMet established acceptance criteria.
Tuohy Borst Valve with Sideport Accessory
Hub GaugingMet established acceptance criteria.
Liquid leakageMet established acceptance criteria.
Air LeakageMet established acceptance criteria.
Separation ForceMet established acceptance criteria.
Unscrewing TorqueMet established acceptance criteria.
Ease of AssemblyMet established acceptance criteria.
Resistance to OverridingMet established acceptance criteria.
Stress CrackingMet established acceptance criteria.
Catheter Simulated Use (Tuohy Borst Valve
with Sideport seal over devices and wires)Met established acceptance criteria.

Biocompatibility

Biocompatibility testing was completed for the previously cleared devices under K122581 and K131492. These results apply to the subject device because it uses the same materials and processes as previously cleared predicate devices. Biocompatibility testing was conducted on the accessories packaged with the previously cleared devices under K131492, which included the modified Tuohy Borst Valve with Sideport to be packaged with the proposed 8F FlowGate² BGC in compliance with EN ISO 10993-1. The results demonstrate that the subject device with its accessories meet biological safety requirements per EN ISO 10993-1: 2009 for externally communicating medical devices with circulating blood contact for less than 24 hours.

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Sterilization and Shelf life

The subject device, including its accessories, are sterilized by 100% EtO and have been adopted into a validated sterilization process in accordance with the principles of ISO 11135:2007, ("Sterilization of health-care products -- Ethylene oxide -- Requirements for the development, validation and routine control of a sterilization process for medical devices") and AAMI TIR 28:2009 ("Product Adoption and Process Equivalency for Ethylene Oxide Sterilization") without deviations.

Summary of Substantial Equivalence

The subject device is substantially equivalent to the predicate devices with regard to device design, materials, intended use, and patient population. The conclusions drawn from the risk assessments, verification and validation testing conducted demonstrate that the subject device performs as designed and has an equivalent performance profile as the predicate devices.