K Number
K163259
Device Name
AXS Offset Delivery Assist Catheter
Date Cleared
2017-07-28

(249 days)

Product Code
Regulation Number
870.1250
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The AXS Offset Delivery Assist Catheter is intended to assist in the delivery of interventional devices, such as distal access catheters, in the neurovasculature.
Device Description
The AXS Offset Delivery Assist Catheter ("AXS Offset") is a sterile, single lumen, variable stiffness catheter designed for use in facilitating the insertion and delivery of appropriately sized interventional devices, such as distal access catheters (DAC), into a selected blood vessel in the neurovascular system. The AXS Offset catheter, when used in conjunction with an appropriately sized steerable guidewire and DAC, provides a smooth interventional device system profile. The distal outer diameter (OD) of the AXS Offset catheter gradually increases from 0.036in at the RO Marker to 0.050in, 2 cm proximal to the RO marker. The bulb section with a 0.050in OD is maintained for 28 cm. then gradually decreases towards the proximal section. The overall distal profile of the AXS Offset catheter acts as a smooth transition and reduces the gap between the outer diameter of a steerable guidewire and inner diameter of a DAC while allowing for continuous saline flush through the DAC. The catheter shaft has a hydrophilic coating to reduce friction during use. The catheter includes a radiopaque marker on the distal end for angiographic visualization and a luer hub on the proximal end allowing attachments for flushing.
More Information

No
The device description and performance studies focus on the mechanical and physical properties of the catheter for delivery assistance, with no mention of AI or ML capabilities.

No
The device is intended to assist in the delivery of other interventional devices and does not directly provide therapy.

No

Explanation: The device, the AXS Offset Delivery Assist Catheter, is described as intended to assist in the delivery of interventional devices, facilitating the insertion and delivery of catheters into a selected blood vessel. Its function is to provide a smooth transition and reduce the gap between devices, not to diagnose a condition or disease.

No

The device description clearly describes a physical catheter with specific dimensions, materials (hydrophilic coating, radiopaque marker), and a luer hub. The performance studies also focus on physical properties and bench testing of the hardware.

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

Here's why:

  • Intended Use: The intended use is to "assist in the delivery of interventional devices... in the neurovasculature." This describes a device used in vivo (within the body) to facilitate a medical procedure.
  • Device Description: The description details a catheter designed for insertion into blood vessels to guide other devices. This is consistent with an interventional medical device, not a diagnostic test performed on samples outside the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information based on laboratory testing.
  • Performance Studies: The performance studies focus on the physical properties and functionality of the catheter within a simulated neurovascular environment (bench testing), not on the accuracy or reliability of a diagnostic test.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is purely mechanical and procedural, assisting in the delivery of other devices within the body.

N/A

Intended Use / Indications for Use

The AXS Offset Delivery Assist Catheter is intended to assist in the delivery of interventional devices, such as distal access catheters, in the neurovasculature.

Product codes

DQY

Device Description

The AXS Offset Delivery Assist Catheter ("AXS Offset") is a sterile, single lumen, variable stiffness catheter designed for use in facilitating the insertion and delivery of appropriately sized interventional devices, such as distal access catheters (DAC), into a selected blood vessel in the neurovascular system.

The AXS Offset catheter, when used in conjunction with an appropriately sized steerable guidewire and DAC, provides a smooth interventional device system profile. The distal outer diameter (OD) of the AXS Offset catheter gradually increases from 0.036in at the RO Marker to 0.050in, 2 cm proximal to the RO marker. The bulb section with a 0.050in OD is maintained for 28 cm. then gradually decreases towards the proximal section. The overall distal profile of the AXS Offset catheter acts as a smooth transition and reduces the gap between the outer diameter of a steerable guidewire and inner diameter of a DAC while allowing for continuous saline flush through the DAC.

The catheter shaft has a hydrophilic coating to reduce friction during use. The catheter includes a radiopaque marker on the distal end for angiographic visualization and a luer hub on the proximal end allowing attachments for flushing.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

neurovascular system

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 following tests were performed on the subject device:

  • Dimensional Verification: Meets acceptance criteria for catheter effective length, uncoated length, distal tip outer diameter, and inner diameter. Substantial Equivalence: XT-27 and AXS Offset meet the same dimensional effective length, uncoated length, and distal tip outer diameter acceptance criteria. For inner diameter, XT-27 and AXS Offset meet their respective dimensional inner diameter acceptance criteria. The inner lumens of both devices are compatible with standard neurovascular guide wires.
  • Dimensional: Maximum Outer Diameter: Meets acceptance criteria for maximum outer diameter. Substantial Equivalence: XT-27 and AXS Offset meet their respective dimensional (maximum outer diameter) acceptance criteria. The differences in the max OD between the XT27 and AXS Offset are related to the differences in the indications for use of both devices.
  • Friction Force: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same friction force acceptance criteria.
  • Catheter Distal Tip Buckling: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same distal tip buckling acceptance criteria.
  • Catheter Tensile Strength: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same catheter tensile strength acceptance criteria.
  • Catheter Hub Tensile Strength: Meets acceptance criteria. Substantial Equivalence: XT-27, Transform, and AXS Offset meet the same catheter hub tensile strength acceptance criteria.
  • Liquid-Leakage: Meets acceptance criteria. Substantial Equivalence: XT-27, Transform, and AXS Offset meet the same liquid-leakage acceptance criteria.
  • Air Aspiration Leakage: Meets acceptance criteria. Substantial Equivalence: XT-27, Transform, and AXS Offset meet the same air aspiration leakage acceptance criteria.
  • Particle Analysis for Catheters: Particle analysis characterization testing completed and is for reference only. Particulate count results for the AXS Offset in all particulate size ranges are similar or lower than the predicate device XT-27.
  • Coating Integrity: Neither the Baseline test articles nor the Post-tracking test articles exhibited any delamination at coating edges (either proximal or distal). The Baseline test articles did not exhibit any coating defects (voids or scratches). The post tracking devices exhibited no anomolies along the 80cm coating length. When considered in conjunction with coating lubricity and durability results and the particulate generation results, the coating functions as intended and has exhibited appropriate integrity (via visual assessment) post simulated use.
  • Track and Advance Force: AXS Offset catheter advance and retraction force in simulated use testing has been demonstrated to be equivalent or lower than the predicate XT-27.
  • Flow Rate: Testing has demonstrated a continuous positive displacement of saline fluid through the lumen of the DAC with the AXS Offset catheter positioned in the DAC lumen. Testing was conducted in a simulated neurovascular tortuosity model.
  • Catheter Kink Radius: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same kink radius acceptance criteria.
  • Catheter Torsional Resistance: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same torsional resistance acceptance criteria.
  • Visual Standards: Visual standards meet acceptance criteria for catheter length being free from extraneous matter and process defects and for catheter distal tip being smooth and rounded. Substantial Equivalence: XT-27 and AXS Offset meet the same visual standards acceptance criteria.
  • Visual and Dimensional Integrity – Chemical Compatibility: Meets acceptance criteria. Substantial Equivalence: XT-27 and AXS Offset meet the same visual and dimensional integrity - chemical compatibility acceptance criteria.
  • Device Trackability: Meets acceptance criteria. Substantial equivalence: XT-27 and AXS Offset meet the same device trackability acceptance criteria. After advancing the Test article with the intermediate catheters in the model, the physicians confirmed that all of the test articles were able to advance to the M1 using standard access methods similar to XT-27.
  • Device - Durability and Integrity: Meets acceptance criteria. The evaluating physicians confirmed that the all test articles maintained their integrity throughout procedure. Substantial Equivalence: XT-27 and AXS Offset meet the device durability and integrity acceptance criteria.
  • Guidewire Compatibility: Meets acceptance criteria. The evaluating physicians confirmed that all test articles allowed smooth advancement and withdrawal of standard guidewires up to 0.018in OD. Substantial Equivalence: XT-27 and AXS Offset meet the same guidewire compatibility acceptance criteria.
  • Labelling requirements: Meets acceptance criteria. The evaluating physicians confirmed that the DFU and labeling of all test articles clearly identify the product and provide information adequate to ensure the safe use of the device. Substantial Equivalence: XT-27 and AXS Offset meet the labeling requirements acceptance criteria.
  • Intended Use Environment: Meets acceptance criteria. The evaluating physicians confirmed that all Test articles withstand conditions that can typically be seen during use environment of the product. Substantial Equivalence: XT-27 and AXS Offset meet the same intended use environment acceptance criteria.
  • Visibility: Meets acceptance criteria. The evaluating physicians confirmed that all test articles are visible under fluoroscopy during delivery to and withdrawal from the intended location. Substantial Equivalence: XT-27 and AXS Offset meet the same visibility acceptance criteria.
  • Packaging: Packaging visual, dimensional, and performance testing meets the acceptance criteria for all packaging components (carton, labels, DFU, and pouch). Substantial Equivalence: XT-27 and AXS Offset meet the same packaging visual, dimensional, and performance acceptance criteria.

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

Not Found

Predicate Device(s)

K113778

Reference Device(s)

K122576

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 a stylized image of three human profiles facing to the right, with flowing lines connecting them.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002 July 28, 2017

Stryker Neurovascular Angelica Beckmann Director, Regulatory Affairs 47900 Bayside Parkway Fremont, California 94538

Re: K163259

Trade/Device Name: AXS Offset Delivery Assist Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: DQY Dated: June 29, 2017 Received: June 30, 2017

Dear Ms. Beckmann:

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 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/Resourcesfor You/Industry/default.htm.

Sincerely,

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

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3

510(k) Summary

Device Trade Name:AXS Offset Delivery Assist Catheter
Common Name:Percutaneous Catheter
Classification Name:Percutaneous Catheter, 21CFR 870.1250 Class II
Product Code:DQY
Submitter:Stryker Neurovascular
47900 Bayside Parkway
Fremont, CA 94538
Facility Registration #2954917
Contact:Angelica Beckmann
Director, Regulatory Affairs
Tel 510 - 413-2900
Fax 510 - 413-2588
Date Prepared:July 27, 2017
Predicate Device:Primary Predicate Device K113778
(clearance granted
April 20, 2012) Excelsior XT-27 Microcatheter Reference Predicate Device
K122576Transform Occlusion Balloon Catheter
(clearance granted
January 11, 2013)

4

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

Device Description

The AXS Offset Delivery Assist Catheter ("AXS Offset") is a sterile, single lumen, variable stiffness catheter designed for use in facilitating the insertion and delivery of appropriately sized interventional devices, such as distal access catheters (DAC), into a selected blood vessel in the neurovascular system.

The AXS Offset catheter, when used in conjunction with an appropriately sized steerable guidewire and DAC, provides a smooth interventional device system profile. The distal outer diameter (OD) of the AXS Offset catheter gradually increases from 0.036in at the RO Marker to 0.050in, 2 cm proximal to the RO marker. The bulb section with a 0.050in OD is maintained for 28 cm. then gradually decreases towards the proximal section. The overall distal profile of the AXS Offset catheter acts as a smooth transition and reduces the gap between the outer diameter of a steerable guidewire and inner diameter of a DAC while allowing for continuous saline flush through the DAC.

The catheter shaft has a hydrophilic coating to reduce friction during use. The catheter includes a radiopaque marker on the distal end for angiographic visualization and a luer hub on the proximal end allowing attachments for flushing.

Accessories

No accessories are provided with the AXS Offset.

Indications for Use

The Indications for Use are similar to the predicate devices and are as follows: The AXS Offset Delivery Assist Catheter is intended to assist in the delivery of interventional devices, such as distal access catheters, in the neurovasculature.

Technological Characteristics and Product Feature Comparison

The subject device, AXS Offset Delivery Assist 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.

5

CharacteristicsSubject DevicePrimary Predicate DeviceReference Predicate Device
Device NameAXS Offset Delivery Assist
CatheterExcelsior® XT-27
MicrocatheterTransform Occlusion Balloon
Catheter
510(k)Current NotificationK113778K122576
Device
Classification/
Product CodeClass II/ DQY
(Percutaneous catheters)Class II/ DQY
(Percutaneous catheters)Class II/MJN
(Temporary Intravascular
Occluding Catheter)
Intended UseThe AXS Offset Delivery
Assist Catheter is intended to
assist in the delivery of
interventional devices, such
as distal access catheters, in
the neurovasculature.Stryker Neurovascular
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.The Stryker Neurovascular
TransForm Occlusion Balloon
Catheters are indicated for use
in the neuro and peripheral
vasculature to temporarily stop
or control blood flow and for
balloon assisted embolization of
intracranial aneurysms.
CharacteristicsSubject DevicePrimary Predicate DeviceReference Predicate Device
Device NameAXS Offset Delivery Assist
CatheterExcelsior® XT-27
MicrocatheterTransform Occlusion Balloon
Catheter
510(k)Current NotificationK113778K122576
Principle of
OperationsDelivery Assist Catheters are
used to access and navigate
the vasculature as well as to
deliver Distal Access
Catheters (DAC). The AXS
Offset Delivery Assist
Catheter is inserted through a
DAC and guided through the
vasculature with the aid of a
guidewire (over-the-wire
catheter).Microcatheters are used to
access and navigate the
vasculature as well as to
deliver diagnostic therapeutic
agents, and/or interventional
devices. Typically these
vascular microcatheters are
inserted with a guide catheter
and guided through the
vasculature with the aid of a
guidewire (over-the-wire
microcatheters).The device is advanced into the
vasculature using an 0.014 inch
OD guidewire and inside a
5F or larger guide catheter
placed in the femoral artery.
The radiopaque markers are
observed under fluoroscopy as a
guide to positioning the balloon
at the intended treatment site.
Once at the treatment site, the
guidewire is used to seal the
distal end of the catheter
allowing inflation of the
balloon. A mixture of saline and
contrast is injected into the
catheter lumen to inflate the
balloon to its nominal volume;
fluoroscopy is used to ensure
proper positioning. Once
beyond the distal tip of the
catheter, the guidewire can be
moved distally or proximally
while maintaining balloon
inflation.

Product Feature Comparison of Subject Device with Predicate Devices (K113778, K122576)

6

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

7

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

CharacteristicsSubject DevicePrimary Predicate DeviceReference Predicate Device
Device NameAXS Offset Delivery AssistExcelsior ® XT-27Transform Occlusion Balloon
CatheterMicrocatheterCatheter
510(k)Current NotificationK113778K122576
Sterilization
MethodEthylene OxideEthylene OxideEthylene Oxide

Design Comparison of Subject Device with Predicate Devices (K113778, K122576)

| | Proposed Device | Predicate Device | Predicate Device | Rationale for difference
(if applicable) |
|-----------------------------------------------------|----------------------------------------|------------------------------------|-----------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Feature | AXS Offset Delivery
Assist Catheter | Excelsior® XT-27
Microcatheter | Transform Occlusion
Balloon Catheter | |
| | Current Notification | K113778 | K122576 | |
| Proximal OD | 3.0F (1.0mm) | 2.9F (0.97mm) | 2.8F (0.95mm) | No significant difference |
| Distal OD | 2.7F (0.91mm) | 2.7F (0.91mm) | 2.7F (0.95mm) | N/A - Same as primary predicate |
| Feature | Proposed Device | Predicate Device | Predicate Device | Rationale for difference
(if applicable) |
| | AXS Offset Delivery
Assist Catheter | Excelsior® XT-27
Microcatheter | Transform Occlusion
Balloon Catheter | |
| | Current Notification | K113778 | K122576 | |
| Maximum
Catheter
Diameter
(distal section) | 3.8F (1.27mm)
*reference figure | 2.7F (0.91mm)
*reference figure | 3.8F(1.27mm)
*reference figure | The AXS Offset outside diameter
is similar to the predicate devices.
AXS Offset has the same
materials as the predicate as seen
in table 13-7. Thrombogenicity
testing demonstrated no risk of
thrombosis for the AXS Offset
Catheter like the predicate device.
Biocompatibility testing was also
completed to show no increased
risk compared to the predicate
devices. The bench testing was
performed in a neurovascular
tortuosity model to confirm the
continuous flush solution will be
adequately maintained between
the AXS Offset and DAC during
use. |
| ID | 0.53mm (.021in) | 0.69mm (0.027in) | 0.31mm (.0124in) | AXS Offset ID of .021" is within
the ranges of both predicate
devices. .021" ID is a common
size for a catheter of this length
and OD. |
| Feature | Proposed Device | Predicate Device | Predicate Device | Rationale for difference
(if applicable) |
| | AXS Offset Delivery
Assist Catheter | Excelsior® XT-27
Microcatheter | Transform Occlusion
Balloon Catheter | |
| | Current Notification | K113778 | K122576 | |
| Hydrophilic
Coating
Length | 80cm | 80cm | 80cm - 83cm | N/A - Same as primary predicate |
| Effective
Length | 150cm | 135 cm
150 cm | 150 cm - 153cm | N/A - Same as primary predicate |
| Tip Length | 2cm | 6 cm
18 cm | 1cm - 3cm | AXS Offset tip length of 2cm is
similar to the predicate devices.
The tip length is used to describe
the section distal of the bulb
feature of the AXS Offset but the
tip length does not significantly
affect the product performance.
The materials of the tip are more
impactful to product
performance. Both AXS Offset
and Excelsior XT-27 have the
same distal tip materials and
distal OD and thus have similar
performance. |
| Tip Shape | Straight | Straight | Straight | N/A - Same as primary predicate |

8

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

9

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

10

Risk Assessment

Risk assessment of the AXS Offset Delivery Assist Catheter has been conducted in accordance with EN ISO 14971 and Stryker Neurovascular's risk management procedures. Stryker Neurovascular has determined that the AXS Offset Delivery Assist Catheter raises no new safety or effectiveness issues.

Results of verification and validation testing have demonstrated the subject device is substantially equivalent to the predicate devices.

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:

11

Stryker Neurovascular

Premarket Notification, Traditional 510(k)

AXS Offset Delivery Assist Catheter

TestTest MethodResults
Dimensional
VerificationVerified dimensions
using specified
measurement toolDimensional verification meets acceptance criteria for catheter
effective length, uncoated length, distal tip outer diameter, and
inner diameter
Substantial Equivalence: XT-27 and AXS Offset meet the same
dimensional effective length, uncoated length, and distal tip outer
diameter acceptance criteria
For inner diameter, XT-27 and AXS Offset meet their respective
dimensional inner diameter acceptance criteria. The inner lumens
of both devices are compatible with standard neurovascular guide
wires.
Dimensional:
Maximum Outer
DiameterVerified dimensions
using specified
measurement toolDimensional verification meets acceptance criteria for maximum
outer diameter
Substantial Equivalence: XT-27 and AXS Offset meet their
respective dimensional (maximum outer diameter) acceptance
criteria. The differences in the max OD between the XT27 and
AXS Offset are related to the differences in the indications for use
of both devices.
Friction ForceMeasured friction
force to determine
the lubricity and
durability of the
coating on a catheter
shaft using a friction
testerFriction force meets acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
friction force acceptance criteria.
Catheter Distal Tip
BucklingMeasured force
required to buckle
distal shaft using tip
buckling testerDistal tip buckling meets acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
distal tip buckling acceptance criteria.
Catheter Tensile
StrengthMeasured catheter
shaft peak tensile
strength using Instron
tensile tester per test
guideline, ISO10555-
1 Peak Tensile ForceCatheter tensile strength meets acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
catheter tensile strength acceptance criteria.
Catheter Hub Tensile
StrengthMeasured catheter
shaft to hub tensile
junction strength
using Instron tensile
tester per test
guideline, ISO10555-
1 Peak Tensile ForceCatheter hub tensile strength meets acceptance criteria
Substantial Equivalence: XT-27, Transform, and AXS Offset meet
the same catheter hub tensile strength acceptance criteria.
Liquid-LeakageDetermined whether
liquid leaks from the
catheter under
pressure per EN ISO
10555-
1:2013 and EN
1707:1996Liquid-leakage meets acceptance criteria
Substantial Equivalence: XT-27, Transform, and AXS Offset meet
the same liquid-leakage acceptance criteria.
Air Aspiration LeakageDetermined whether
air leaks into the hub
assembly during
aspiration per EN
ISO 10555-1:2013
and EN 1707:1996.Air aspiration leakage meets acceptance criteria
Substantial Equivalence: XT-27, Transform, and AXS Offset meet
the same air aspiration leakage acceptance criteria.
Particle Analysis for
CathetersPerformed simulated
use procedures for in vitro acute phase
particulate
characterization
using a particle
counterParticle analysis characterization testing completed and is for
reference only.
Particulate count results for the AXS Offset in all particulate size
ranges are similar or lower than the predicate device XT-27
Coating IntegrityChecked visual
condition of catheter
and noted
observations of the
catheter coatings
before and after
simulated useNeither the Baseline test articles nor the Post-tracking test articles
exhibited any delamination at coating edges (either proximal or
distal). The Baseline test articles did not exhibit any coating defects
(voids or scratches). The post tracking devices exhibited no
anomolies along the 80cm coating length. When considered in
conjunction with coating lubricity and durability results and the
particulate generation results, the coating functions as intended and
has exhibited appropriate integrity (via visual assessment) post
simulated use.
Track and Advance
ForceMeasured the
advance and
retraction force in
simulated use
conditions from the
petrous segment of
the internal carotid
artery to the M1 of
the middle cerebral
artery.AXS Offset catheter advance and retraction force in simulated use
testing has been demonstrated to be equivalent or lower than the
predicate XT-27.
Flow RateMeasured flow rate
for saline infusion
through a Distal
Access Catheter
(DAC) when the
AXS Offset catheter
was positioned within
the lumen of the
DAC.Testing has demonstrated a continuous positive displacement of
saline fluid through the lumen of the DAC with the AXS Offset
catheter positioned in the DAC lumen. Testing was conducted in a
simulated neurovascular tortuosity model.
Catheter Kink RadiusMeasured the kink
radius of catheter
using a fixtureCatheter kink radius meets acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
kink radius acceptance criteria.
Catheter Torsional
ResistanceMeasured the
strength of catheter
shaft while it rotates
in a clinically
relevant vascular path
to determine how
many turns (360-
degree rotations) are
required to break the
shaftCatheter torsional resistance meets acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
torsional resistance acceptance criteria.
Visual StandardsVisually checked
catheter length for
extraneous matter
and process defects.
Additionally,
checked for smooth
and rounded distal tip
using specified
measurement toolsVisual standards meet acceptance criteria for catheter length being
free from extraneous matter and process defects and for catheter
distal tip being smooth and rounded.
Substantial Equivalence: XT-27 and AXS Offset meet the same
visual standards acceptance criteria.
Visual and
Dimensional Integrity
– Chemical
CompatibilityPerformed visual,
dimensional, and
mandrel passage
examinations to
determine visual and
dimensional integrity
of the hub, inner
lumen, and outer
distal region of
catheter after
exposure to saline,
non-ionic contrast,
and ionic contrast.Visual and Dimensional Integrity - Chemical Compatibility meets
acceptance criteria
Substantial Equivalence: XT-27 and AXS Offset meet the same
visual and dimensional integrity - chemical compatibility
acceptance criteria.
Device TrackabilityThe device was
advanced to the M1
using standard access
methods similar to
XT-27. In order to
meet acceptance
criteria, the evaluating
physician/s must state
that the test articles
can advance to the
M1 in conjunction
with the intermediate
catheter in the bench
model.Device Trackability meets acceptance criteria
Substantial equivalence: XT-27 and AXS Offset meet the same
device trackability acceptance criteria.
After advancing the Test article with the intermediate catheters in
the model, the physicians confirmed that all of the test articles were
able to advance to the M1 using standard access methods similar to
XT-27.
Device - Durability
and IntegrityThe integrity of the
device was assessed
throughout the
duration of the
procedure using the
bench model. In order
to meet acceptance
criteria, the evaluating
physician/s must state
that all test articles
maintain their
integrity throughout
procedure.Device Durability and Integrity meets acceptance criteria
The evaluating physicians confirmed that the all test articles
maintained their integrity throughout procedure.
Substantial Equivalence: XT-27 and AXS Offset meet the device-
durability and integrity acceptance criteria.
Guidewire
CompatibilityGuidewires up to
0.018in OD were
allowed to advance
and withdraw from
the AXS Offset
device during the
procedure using the
bench model. InGuidewire Compatibility meets acceptance criteria
The evaluating physicians confirmed that all test articles allowed
smooth advancement and withdrawal of standard guidewires up to
0.018in OD.
order to meet
acceptance criteria,
the evaluating
physician/s must state
that all test articles
allow smooth
advancement and
withdrawal of
standard guidewires
up to 0.018in OD.Substantial Equivalence: XT-27 and AXS Offset meet the same
guidewire compatibility acceptance criteria.
Labelling requirementsThe physician read
the DFU and labeling.
In order to meet
acceptance criteria,
the evaluating
physician/s must state
that DFU and labeling
of all test articles
clearly identify the
product and provide
information adequate
to ensure the safe use
of the device.Labelling Requirements meet acceptance criteria
The evaluating physicians confirmed that the DFU and labeling of
all test articles clearly identify the product and provide information
adequate to ensure the safe use of the device.
Substantial Equivalence: XT-27 and AXS Offset meet the labeling
requirements acceptance criteria.
Intended Use
EnvironmentDuring the procedure
using the bench
model, the device was
assessed whether it
withstood the
simulated use
conditions. In order
to meet acceptance
criteria, the evaluating
physician/s must state
that all test articles
can withstand
conditions that can
typically be seen
during use
environment of the
product.Intended Use Environment meets acceptance criteria
The evaluating physicians confirmed that all Test articles withstand
conditions that can typically be seen during use environment of the
product.
Substantial Equivalence: XT-27 and AXS Offset meet the same
intended use environment acceptance criteria.

12

Stryker Neurovascular

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

13

Stryker Neurovascular

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

14

Stryker Neurovascular

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

15

Stryker Neurovascular Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

| Visibility | The visibility of the
tip of the AXS Offset
(marker) was assessed
using fluoroscopy
during delivery to and
withdrawal from the
intended location in
the bench model. In
order to meet
acceptance criteria,
the evaluating
physician/s must state
that all test articles are
visible under
fluoroscopy during
delivery to and
withdrawal from the
intended location. | Visibility meets acceptance criteria
The evaluating physicians confirmed that all test articles are visible
under fluoroscopy during delivery to and withdrawal from the
intended location.
Substantial Equivalence: XT-27 and AXS Offset meet the same
visibility acceptance criteria. |
|------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Packaging | Performed packaging
visual, dimensional,
and performance
testing on carton,
labels, DFU, and
pouch | Packaging visual, dimensional, and performance testing meets the
acceptance criteria for all packaging components (carton, labels,
DFU, and pouch).
Substantial Equivalence: XT-27 and AXS Offset meet the same
packaging visual, dimensional, and performance acceptance criteria. |

Biocompatibility

The AXS Offset Delivery Assist Catheter was assessed for impact to biocompatibility. All proposed materials to be used in the AXS Offset Delivery Assist Catheter as per this assessment have a history of safe clinical use throughout the medical device industry and/or within Stryker Neurovascular and have supporting biocompatibility data. The materials used and the manufacturing process used in the AXS Offset Delivery Assist Catheter are the same or very similar to materials used in the cleared reference predicate Transform Occlusion Balloon Catheter (K122576).

The history of safe use and supporting biological test data leveraged from for the reference predicate devices noted above, indicates potential exposure to these existing materials at the amounts present under the proposed clinical conditions of use for the AXS Offset Delivery Assist Catheter will be toxicologically insignificant.

The minor material and manufacturing differences between the AXS Offset Delivery Assist Catheter and the cleared reference predicate device are considered low risk in terms of impact to the biocompatibility of the AXS Offset Delivery Assist Catheter. Therefore, the supporting Transform Occlusion Balloon Catheter (K122576) biocompatibility test data presented in Transform Occlusion Balloon Catheter Biocompatibility Results Summary Table are applicable to the AXS Offset Delivery Assist Catheter.

Although these differences are considered low risk for the biocompatibility of the AXS

16

Offset Delivery Assist Catheter, screening tests were conducted to further provide supporting evidence that these differences do not adversely impact the product. The AXS Offset Delivery Assist Catheter Biocompatibility Results Summary table summarizes the biocompatibility tests that were conducted using the AXS Offset Delivery Assist Catheter. EN ISO 10993 parts are referenced where applicable.

TestTest SummaryConclusion
MEM Elution
Cytotoxicity/Part 5The test article extract
showed no evidence of
causing cell lysis or toxicity,
with a grade of 0 (no
reactivity).Pass.
No cytotoxicity or cell lysis.
The test article is considered
non-cytotoxic.
Hemolysis Extract/Direct
Contact Method/Part 4The hemolytic index for the
test article in direct contact
with blood and for the
extractwas /Part 18The results for the test article
were:
Non-volatile residue: 7 mg
Residue on ignition: /
Part 18The results for the test article
were:
Non-volatile residue: 1 mg
Residue on ignition: 0.1ug/dm2Pass.
The results for the test article were
considered passing.
In-Vivo ThromboresistanceFor both the test article and
control, platelet counts and
APTT time were within normal
ranges. The test article and
control article scored the same
for thrombosis and vessel
patency.Pass.
The test article demonstrated
comparable thromboresistance to
the control article.

AXS Offset Delivery Assist Catheter Biocompatibility Results Summary

The following tests were leveraged from biocompatibility testing conducted with the Transform Occlusion Balloon Catheter:

17

Transform Occlusion Balloon Catheter Biocompatibility Results Summary

18

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

Biocompatibility testing previously conducted for Transform Occlusion Balloon Catheter product is representative of the AXS Offset Delivery Assist Catheter product due to similarity of materials, manufacturing processes and design. There are no new manufacturing processes, processing aids or chemicals (fillers, additives, cleaning agents etc.) for the manufacture of the AXS Offset device. Screening tests were conducted on AXS Offset Delivery Assist Catheter devices to further provide supporting evidence that the minor differences do not adversely impact the product.

Following completion of testing and review of materials, the AXS Offset Delivery Assist Catheter is considered to have no residual risk of biological hazards. It meets requirements as outlined in EN ISO 10993-1 Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing within a risk management process for an externally communicating, circulating blood and limited contact (≤24 hrs) duration device.

19

Sterilization and Shelf life

The AXS Catalyst Distal Access Catheter and all system components are sterilized with100% Ethylene Oxide. The AXS Catalyst Distal Access Catheter is provided sterile to a sterility assurance level (SAL) of 10-6, and is for single use only.

The test results for this device are within the ANSI/AAMI ST72:2011 Endotoxin Limit of 20 Endotoxin Units per device (EU/device). Bacterial endotoxin (pyrogen) testing of the AXS Offset Delivery Assist Catheter will be monitored to ensure product release meets specifications.

Ethylene oxide (EO) residuals on a sample representative of the AXS Catalyst DistalAccess Catheter are less than the maximum allowed for EO residuals per EN ISO 10993-7 for a limited contact delivery system -externally communicating.

The labeled shelf life for the AXS Offset is 3 years. Bench testing was conducted on accelerated aged AXS Offset Delivery Assist Catheters to confirm the shelf-life of the device is maintained over the duration of the labeled shelf-life.

Summary of Substantial Equivalence

The subject device is substantially equivalent to the predicate devices based on similar intended use / indications for use, same or similar materials, same fundamental design, and the same fundamental operating principles. Minor differences between the subject and predicate devices do not introduce different questions of safety and effectiveness. The conclusions drawn from risk assessments and the bench testing conducted using the subject device demonstrate that the device performs as designed, is suitable for its intended use, and that the benefits of the device outweigh any residual risks when used in accordance with device Instructions for Use.

20

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter

| Feature | Proposed Device
AXS Offset
Delivery Assist
Catheter
Current
Notification | Predicate Device
Excelsior® XT-
27 Microcatheter
K113778 | Predicate
Device
Transform
Occlusion
Balloon
Catheter
K122576 | Rationale for difference
(if applicable) |
|--------------------------------------------------------|-----------------------------------------------------------------------------------------|-------------------------------------------------------------------|---------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Proximal
Outer
Diameter | 3.0F (1.0mm) | 2.9F (0.97mm) | 2.8F (0.95mm) | No significant difference |
| Distal Tip
Outer
Diameter | 2.7F (0.91mm) | 2.7F (0.91mm) | 2.7F (0.95mm) | N/A - Same as primary
predicate |
| Maximum
Catheter
Diameter
(distal
section) | 3.8F (1.27mm) | 2.7F (0.91mm) | 3.8F(1.27mm) | The AXS Offset outside
diameter is the same as
the Transform and
similar to the XT-27
predicate devices. The
differences between
XT27 and AXS Offset
are related to the
differences in the
indications for use. |
| Inner
Diameter | 0.53mm (.021in) | 0.69mm (0.027in) | 0.31mm
(.0124in) | AXS Offset ID of .021"
is within the ranges of
both predicate devices.
.021" ID is a common
size for a catheter of this
length and OD. |
| Hydrophilic
Coating
Length | 80cm | 80cm | 80cm - 83cm | N/A - Same as primary
predicate |
| Feature | Proposed Device
AXS Offset
Delivery Assist
Catheter
Current
Notification | Predicate Device
Excelsior® XT-
27 Microcatheter
K113778 | Predicate
Device
Transform
Occlusion
Balloon
Catheter
K122576 | Rationale for difference
(if applicable) |
| Effective
Length | 150cm | 135 cm
150 cm | 150 cm - 153cm | N/A - Same as primary
predicate |
| Tip Length | 2cm | 6 cm
18 cm | 1cm - 3cm | AXS Offset tip length of
2cm is in the range of the
predicate Transform, but
much shorter than the
XT-27 predicate. Tip
materials impact product
performance more than
tip length. Both AXS
Offset and Excelsior XT-
27 have the same distal
tip materials and distal
OD and thus have similar
performance. |
| Tip Shape | Straight | Straight
Pre-shaped | Straight | N/A - Same as primary
predicate |

Comparison Summary Table for Design

21

Premarket Notification, Traditional 510(k) AXS Offset Delivery Assist Catheter