(90 days)
- The Trevo Retriever is indicated for use to restore blood flow in the neurovasculature by removing thrombus for the treatment of acute ischemic stroke to reduce disability in patients with a persistent, proximal anterior circulation, large vessel occlusion, and smaller core infarcts who have first received intravenous tissue plasminogen activator (IV t-PA). Endovascular therapy with the device should start within 6 hours of symptom onset.
- The Trevo Retriever is intended to restore blood flow in the neurovasculature by removing thrombus in patients experiencing ischemic stroke within 8 hours of symptom onset. Patients who are ineligible for intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment.
- The Trevo Retriever is indicated for use to restore blood flow in the neurovasculature by removing thrombus for the treatment of acute ischemic stroke to reduce disability in patients with a persistent, proximal anterior circulation, large vessel occlusion of the internal carotid artery (ICA) or middle cerebral artery (MCA)-M1 segments with smaller core infarcts (0-50 cc for age
The Trevo Retriever consists of a flexible, tapered core wire with a shaped section at the distal end. Platinum markers at the distal end allow fluoroscopic visualization. In addition, the shaped section is also radiopaque. Retriever dimensions are indicated on product label. The Retriever has a hydrophilic coating to reduce friction during use. The Retriever has a shaft marker to indicate proximity of Retriever tip relative to Microcatheter tip. A torque device is provided with the Retriever to facilitate manipulation and retrieval. An insertion tool is provided to introduce the Retriever into a Microcatheter. The Insertion Tool is a sheath in which the Retriever comes preloaded. Once half the retriever's length is inserted into the microcatheter, the insertion tool is removed. Retrievers have a modified proximal end that permits attachment of the Abbott Vascular DOC Guide Wire Extension (REF 22260). Joining the Guide Wire Extension to the Retriever facilitates removal or exchange of a catheter while maintaining the Retriever position in anatomy. After the exchange has been completed, the extension can be detached.
The provided text is a 510(k) Summary for the Stryker Neurovascular Trevo XP ProVue Retriever. This document primarily focuses on demonstrating substantial equivalence to predicate devices, rather than presenting a detailed clinical study with acceptance criteria for an AI device. The information requested in your prompt (e.g., acceptance criteria for device performance, sample sizes for test/training sets, expert qualifications, ground truth establishment methods, MRMC studies) is typically found in regulatory submissions for AI/ML-based medical devices, which assess algorithm performance.
The provided document does not contain the specific type of information needed to fully answer your request regarding acceptance criteria and performance data for an AI-powered device.
However, I can extract the information that is present concerning the Trevo Retriever, which is a mechanical thrombectomy device, and interpret it in the context of device performance, even if it's not an AI device.
Let's break down what is available and what is not:
What is Available (relevant to a physical medical device, not AI/ML):
- Device Type: Neurovascular Mechanical Thrombectomy Device (a physical medical device, not an AI/ML algorithm).
- Purpose: To restore blood flow in the neurovasculature by removing thrombus for the treatment of acute ischemic stroke.
- Performance Data - Non-Clinical:
- Test: Simulated Use
- Test Method Summary: "Simulated Use testing utilized a neurovascular model with a re-circulating water bath at 37℃ to simulate the human arterial circulation and to assess the device's ability to retrieve the clot and achieve recanalization."
- Conclusion/Performance: "Simulated Use met acceptance criteria."
- Performance Data - Clinical:
- Data Source: Analysis of Real World Data (RWD) from the Trevo Retriever Registry.
- Purpose: To assess safety or effectiveness on the combination use of Trevo Retriever and intermediate catheter aspiration approach.
- Additional Support: Comprehensive review of relevant clinical literature.
What is NOT available (and would be expected for an AI/ML device as per your prompt):
- A table of acceptance criteria and reported device performance for an AI/ML algorithm. The document only states that "Simulated Use met acceptance criteria" without specifying the precise quantitative criteria or results.
- Sample sizes used for the test set and data provenance (e.g., country of origin, retrospective/prospective). The "Simulated Use" refers to a bench test, not a patient test set, and the "Trevo Retriever Registry" is mentioned for clinical data, but no specifics about its use as a "test set" for performance evaluation against acceptance criteria are given.
- Number of experts used to establish ground truth for the test set and their qualifications. This is relevant for AI/ML evaluation.
- Adjudication method (e.g., 2+1, 3+1, none) for the test set.
- If a multi-reader multi-case (MRMC) comparative effectiveness study was done, and its effect size. This is specific to AI clinical utility.
- If a standalone (algorithm only without human-in-the-loop performance) was done.
- The type of ground truth used (expert consensus, pathology, outcomes data, etc.).
- The sample size for the training set.
- How the ground truth for the training set was established.
Summary in relation to your prompt, given the provided document:
Since the provided text describes a physical medical device (a thrombectomy device) and not an AI/ML algorithm, most of the requested points related to AI/ML software validation (like training set, ground truth experts, MRMC studies) are not applicable and thus not present in the document.
The "acceptance criteria" mentioned in the non-clinical performance section only states that the "Simulated Use met acceptance criteria," but it does not specify what those criteria were (e.g., success rate, time to recanalization, etc.) nor does it provide the exact performance metrics achieved.
Therefore, I cannot construct the table or provide the detailed answers to most of your questions based on the provided text, as it does not pertain to an AI/ML device.
§ 882.5600 Neurovascular mechanical thrombectomy device for acute ischemic stroke treatment.
(a)
Identification. A neurovascular mechanical thrombectomy device for acute ischemic stroke treatment is a prescription device used in the treatment of acute ischemic stroke to improve clinical outcomes. The device is delivered into the neurovasculature with an endovascular approach, mechanically removes thrombus from the body, and restores blood flow in the neurovasculature.(b)
Classification. Class II (special controls). The special controls for this device are:(1) The patient contacting components of the device must be demonstrated to be biocompatible.
(2) Non-clinical performance testing must demonstrate that the device performs as intended under anticipated conditions of use, including:
(i) Mechanical testing to demonstrate the device can withstand anticipated tensile, torsional, and compressive forces.
(ii) Mechanical testing to evaluate the radial forces exerted by the device.
(iii) Non-clinical testing to verify the dimensions of the device.
(iv) Non-clinical testing must demonstrate the device can be delivered to the target location in the neurovasculature and retrieve simulated thrombus under simulated use conditions.
(v) Non-clinical testing must demonstrate the device is radiopaque and can be visualized.
(vi) Non-clinical testing must evaluate the coating integrity and particulates under simulated use conditions.
(vii) Animal testing must evaluate the safety of the device, including damage to the vessels or tissue under anticipated use conditions.
(3) Performance data must support the sterility and pyrogenicity of the patient contacting components of the device.
(4) Performance data must support the shelf-life of the device by demonstrating continued sterility, package integrity, and device functionality over the specified shelf-life.
(5) Clinical performance testing of the device must demonstrate the device performs as intended for use in the treatment of acute ischemic stroke and must capture any adverse events associated with the device and procedure.
(6) The labeling must include:
(i) Information on the specific patient population for which the device is intended for use in the treatment of acute ischemic stroke, including but not limited to, specifying time from symptom onset, vessels or location of the neurovasculature that can be accessed for treatment, and limitations on core infarct size.
(ii) Detailed instructions on proper device preparation and use for thrombus retrieval from the neurovasculature.
(iii) A summary of the clinical testing results, including a detailed summary of the device- and procedure-related complications and adverse events.
(iv) A shelf life.