K Number
K210562
Device Name
HRSpheres Narrow-Size Embolic Microspheres
Date Cleared
2021-10-01

(218 days)

Product Code
Regulation Number
870.3300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
HRSpheres Narrow-Size Embolic Microspheres are intended to be used for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors, including uterine fibroids.
Device Description
HRSpheres Narrow-Size Embolic Microspheres are compressible hydrogel microspheres with a regular shape, smooth surface, and calibrated size, which are formed as a result of chemical modification on polyvinyl alcohol (PVA) materials. HRSpheres Narrow-Size Embolic Microspheres consist of a macromer derived from PVA, and are hydrophilic, non-resorbable, and are available in a variety of diameters ranging from 70 - 1,200 um. The preservation solution is 0.9% sodium chloride solution. The water content of a fully polymerized microsphere is 91% ~ 94%. Microspheres are compressible to enable smooth delivery through the indicated delivery catheter. The HRSpheres are available in dyed (blue) and clear (undyed with natural color). Blue-dyed microspheres aid in the visualization of the microspheres in the delivery syringe. HRSpheres Narrow-Size Embolic Microspheres are packaged in sterile sealed glass vials for single use only and available with 1 mL, 2 mL, or 3 mL microspheres volumes per vial. HRSpheres Narrow-Size Embolic Microspheres can be delivered to a targeted area through typical microcatheters in the 1.7 – 4 Fr range. By blocking the blood supply to the target area, the tumor or malformation is starved of nutrients and shrinks in size. At the time of use. HRSpheres Narrow-Size Embolic Microspheres are mixed with a nonionic contrast agent to form a suspension solution and aid in visualization during a procedure.
More Information

No
The device description and performance studies focus on the physical and biological properties of the microspheres, with no mention of AI or ML for image analysis, treatment planning, or any other function.

Yes
The device is intended to be used for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors, which is a therapeutic intervention aimed at treating medical conditions.

No

HRSpheres Narrow-Size Embolic Microspheres are used for embolization, which is a therapeutic procedure to block blood supply. They are designed to treat conditions like arteriovenous malformations and hypervascular tumors by shrinking them, not to diagnose them.

No

The device description clearly states that the device is composed of physical microspheres made from modified PVA materials, which are delivered via catheter. This is a physical medical device, not a software-only device.

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

Here's why:

  • Intended Use: The intended use is for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors. This is a therapeutic procedure performed within the body to block blood vessels.
  • Device Description: The device is a physical material (microspheres) delivered via catheter to a target area within the body.
  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body (like blood, urine, or tissue) to detect diseases, conditions, or infections. This device does not perform any such testing.

The device is an implantable medical device used for therapeutic purposes.

N/A

Intended Use / Indications for Use

HRSpheres Narrow-Size Embolic Microspheres are intended to be used for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors, including uterine fibroids.

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

KRD, NAJ

Device Description

HRSpheres Narrow-Size Embolic Microspheres are compressible hydrogel microspheres with a regular shape, smooth surface, and calibrated size, which are formed as a result of chemical modification on polyvinyl alcohol (PVA) materials. HRSpheres Narrow-Size Embolic Microspheres consist of a macromer derived from PVA, and are hydrophilic, non-resorbable, and are available in a variety of diameters ranging from 70 - 1,200 um. The preservation solution is 0.9% sodium chloride solution. The water content of a fully polymerized microsphere is 91% ~ 94%. Microspheres are compressible to enable smooth delivery through the indicated delivery catheter. The HRSpheres are available in dyed (blue) and clear (undyed with natural color). Blue-dyed microspheres aid in the visualization of the microspheres in the delivery syringe. HRSpheres Narrow-Size Embolic Microspheres are packaged in sterile sealed glass vials for single use only and available with 1 mL, 2 mL, or 3 mL microspheres volumes per vial.

HRSpheres Narrow-Size Embolic Microspheres can be delivered to a targeted area through typical microcatheters in the 1.7 – 4 Fr range. By blocking the blood supply to the target area, the tumor or malformation is starved of nutrients and shrinks in size. At the time of use. HRSpheres Narrow-Size Embolic Microspheres are mixed with a nonionic contrast agent to form a suspension solution and aid in visualization during a procedure.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Mixed with non-ionic contrast media prior to injection
Via catheter under fluoroscopic visualization

Anatomical Site

Arteriovenous malformations (AVMs), hypervascular tumors, uterine fibroids.

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

An animal study was performed on the healthy swine models to evaluate the safety and effectiveness of the HRSpheres Narrow-Size Embolic Microspheres. A total of 15 female domestic swine were selected for evaluation. The animal study was intended to simulate the clinical application of the embolization microspheres by interventional procedure for partial renal artery embolization. Seven pigs were selected for embolization with the test article (75 - 125 um), and the other 8 pigs were selected for embolization with the control article (CalliSpheres Polyvinyl Alcohol Embolization Microspheres; K173871) (100 - 300 um). Several preoperative and postoperative observation time points were selected, including 3, 8 and 29 days after embolization.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

In-Vitro Bench Testing:
Test Items: Appearance, Compressibility, Quantity, Size Range, Suspension, Catheter Deliverability, Water Content, pH, Impurities and residual solvents, Sterility, Bacterial endotoxin. All results met predefined acceptance criteria.

Packaging Integrity and Shelf Life:
Accelerated aging tests equivalent to 3 years of shelf life were carried out on HRSpheres Narrow-Size Embolic Microspheres, with 3 batches of each tested for all device specifications. Accelerated aging tests for package integrity were also carried out on the packaging materials including the bottles, rubber closures, and aluminum plastic covers.
Results: All samples met specifications, supporting a 3 year shelf life.

Sterilization and Shelf Life:
Sterilization validation to a sterility assurance level (SAL) of 10^-6 using the Overkill Approach per ANSI/AAMI/ISO 17665-1:2006(R)2013 by moist heat sterilization (121 degrees C, 30 min).
Bacterial endotoxins tested per USP Bacterial Endotoxins Test to a level of not more than 0.5 EU/mL.

Chemical Characterization:
Exhaustive extraction of microspheres in purified water, ethanol, and hexane. Extracts analyzed per FTIR, GC-MS and UPLC-MS. Water extract analyzed by ICP-MS. Risk analysis determined low risk of chronic toxicity and carcinogenicity.

Biocompatibility Evaluation:
Tests conducted per ISO 10993 standards and FDA guidance.

  • MTT Cytotoxicity Test: Non-cytotoxic
  • ISO Guinea Pig Maximization Sensitization Test: Non-sensitizer
  • ISO Intracutaneous Study in Rabbits: Non-irritant
  • ISO Acute Systemic Toxicity Study in Mice: No mortality or evidence of systemic toxicity
  • ASTM Hemolysis Study: Non-hemolytic
  • ASTM Partial Thromboplastin Time: Non-activator
  • SC5b-9 Complement Activation Assay: Potential activators, but test article lower than control and statistically different.
  • USP Rabbit Pyrogen Study, Material Mediated: Non-pyrogenic
  • Genotoxicity Mouse Lymphoma Assay: Non-mutagenic
  • Bacterial Reverse Mutation Study: Non-mutagenic
  • ISO Systemic Toxicity Study in Rats Following Subcutaneous Implantation, 13 Weeks: No evidence of systemic toxicity, minimal to no microscopic reaction.
  • ISO Muscle Implantation Study in Rabbits, 4 Weeks: Macroscopic reaction not significant, minimal to no microscopic reaction.
  • ISO Muscle Implantation Study in Rabbits, 13 Weeks: Macroscopic reaction not significant, slight microscopic reaction.
  • Chronic Systemic Toxicity and Carcinogenicity Evaluation: Biological risk assessment supported low risk.

Animal Study Testing:
Study Type: Animal study
Sample Size: 15 female domestic swine (7 for test article, 8 for control article)
Study Design: Partial renal artery embolization, with observation time points at 3, 8, and 29 days after embolization.
Key Results:

  • Comparison of recanalization of the vessels/durability of occlusion: Not explicitly stated, but overall comparable safety and effectiveness.
  • Comparison of local and systemic foreign body reactions: Tissue reactions were mild and comparable between groups.
  • Comparison of the ease of delivery: Not explicitly stated, but overall comparable safety and effectiveness.
  • Comparison of the rupture or puncture of the blood vessels: Not explicitly stated, but overall comparable safety and effectiveness.
  • Comparison of the non-target embolization/device migration: Not explicitly stated, but overall comparable safety and effectiveness.
  • Comparison of local and systemic foreign body reactions: Tissue reactions were mild and comparable between groups.
    Preoperative and postoperative clinicopathological examination results demonstrated that there was no significant difference between test group and control group with respect to adverse reactions. The results demonstrate that the subject device is as safe and effective as the cleared CalliSphere Embolic Microspheres (K173871).

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.

K173871

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

§ 870.3300 Vascular embolization device.

(a)
Identification. A vascular embolization device is an intravascular implant intended to control hemorrhaging due to aneurysms, certain types of tumors (e.g., nephroma, hepatoma, uterine fibroids), and arteriovenous malformations. This does not include cyanoacrylates and other embolic agents, which act by polymerization or precipitation. Embolization devices used in neurovascular applications are also not included in this classification, see § 882.5950 of this chapter.(b)
Classification. Class II (special controls.) The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance Document: Vascular and Neurovascular Embolization Devices.” For availability of this guidance document, see § 870.1(e).

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October 1, 2021

Suzhou Hengrui Hongyuan Medical Co., Ltd. Qianqian Zhang Regulatory Affairs Engineer Building B9 Unit 201, No. 218 Xinghu Road, SIP Suzhou, Jiangsu 215123 China

Re: K210562

Trade/Device Name: HRSpheres Narrow-Size Embolic Microspheres Regulation Number: 21 CFR§ 870.3300 Regulation Name: Vascular embolization device Regulatory Class: II Product Code: KRD, NAJ Dated: September 8, 2021 Received: September 16, 2021

Dear Qianqian Zhang:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

1

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 801and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatoryinformation/postmarketing-safety-reporting-combination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Jason R. Roberts, Ph.D. Assistant Director DHT3B: Division of Reproductive. Gynecology and Urology Devices OHT3: Office of GastroRenal, ObGyn, General Hospital and Urology Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K210562

Device Name

HRSpheres Narrow-Size Embolic Microspheres

Indications for Use (Describe)

HRSpheres Narrow-Size Embolic Microspheres are intended to be used for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors, including uterine fibroids.

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

HRSpheres Narrow-Size Embolic Microspheres (per 21 CFR 807.92)

1. Submitter

Submitter Name:Suzhou Hengrui Hongyuan Medical Co., Ltd
Address:Building B9 Unit 201, No. 218 Xinghu Road, SIP, Suzhou,
Jiangsu, China 215123
Phone:+86-512-6835-6665
Contact Person:Qianqian Zhang
Email:zhangqianqian@hrmedical.com.cn

September 30, 2021

2. Subject Device

Date Prepared:

Device Name:HRSpheres Narrow-Size Embolic Microspheres
Common or Usual Name:Polyvinyl Alcohol Embolic Microspheres
Classification Name:Vascular Embolization Device (21 CFR 870.3300)
Regulatory Class:Class II
Product Code:KRD (device, vascular, for promoting embolization),
NAJ (agents, embolic, for treatment of uterine fibroids)

3. Predicate Device

Device Name:CalliSpheres Embolic Microspheres, 8Spheres
Embolic Microspheres
510(k) number:K173871
Manufacturer:Suzhou Hengrui Callisyn Biomedical Co., Ltd
Regulation Number:21 CFR 870.3300
Product Code:KRD, NAJ

The predicate device has not been subject to any design-related recall.

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4. Device Description

HRSpheres Narrow-Size Embolic Microspheres are compressible hydrogel microspheres with a regular shape, smooth surface, and calibrated size, which are formed as a result of chemical modification on polyvinyl alcohol (PVA) materials. HRSpheres Narrow-Size Embolic Microspheres consist of a macromer derived from PVA, and are hydrophilic, non-resorbable, and are available in a variety of diameters ranging from 70 - 1,200 um. The preservation solution is 0.9% sodium chloride solution. The water content of a fully polymerized microsphere is 91% ~ 94%. Microspheres are compressible to enable smooth delivery through the indicated delivery catheter. The HRSpheres are available in dyed (blue) and clear (undyed with natural color). Blue-dyed microspheres aid in the visualization of the microspheres in the delivery syringe. HRSpheres Narrow-Size Embolic Microspheres are packaged in sterile sealed glass vials for single use only and available with 1 mL, 2 mL, or 3 mL microspheres volumes per vial.

HRSpheres Narrow-Size Embolic Microspheres can be delivered to a targeted area through typical microcatheters in the 1.7 – 4 Fr range. By blocking the blood supply to the target area, the tumor or malformation is starved of nutrients and shrinks in size. At the time of use. HRSpheres Narrow-Size Embolic Microspheres are mixed with a nonionic contrast agent to form a suspension solution and aid in visualization during a procedure. The device configurations are described in Table 1. Product codes beginning with "B" represent microspheres with blue dye (Reactive Blue #4) and codes beginning with "C" represent undyed microspheres. Among the various size ranges of HRSpheres Narrow-Size Embolic Microspheres, the sizes that can be used for uterine fibroid embolization are 500 um, 700um, 900 um, 1200 um.

Indication
Product
CodeCalibrated
size (µm)Size Range
(µm)QuantityHypervascular
Tumors /
Arteriovenous
MalformationsUterine
Fibroid
B107S0077070-1001 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
B207S0072 mL microspheres: 7 mL
0.9% sodium chloride solution
B306S0073 mL microspheres: 6 mL
0.9% sodium chloride solution
B107S01010075-1251 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
Product
CodeCalibrated
size (µm)Size Range
(µm)QuantityIndication
Hypervascular
Tumors /
Arteriovenous
MalformationsUterine
Fibroid
B207S0100.9% sodium chloride solution
2 mL microspheres: 7 mL
B306S0070.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S0250.9% sodium chloride solution
1 mL microspheres: 7 mL
B207S025250200-3000.9% sodium chloride solution
2 mL microspheres: 7 mLYesNo
B306S0250.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S0400.9% sodium chloride solution
1 mL microspheres: 7 mL
B207S040400350-4500.9% sodium chloride solution
2 mL microspheres: 7 mLYesNo
B306S0400.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S0500.9% sodium chloride solution
1 mL microspheres: 7 mL
B207S050500480-5800.9% sodium chloride solution
2 mL microspheres: 7 mLYesYes
B306S0500.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S0700.9% sodium chloride solution
1 mL microspheres: 7 mL
B207S070700650-7500.9% sodium chloride solution
2 mL microspheres: 7 mLYesYes
B306S0700.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S0900.9% sodium chloride solution
1 mL microspheres: 7 mL
B207S090900825-9750.9% sodium chloride solution
2 mL microspheres: 7 mLYesYes
B306S0900.9% sodium chloride solution
3 mL microspheres: 6 mL
B107S1201,2001,000-
1,2000.9% sodium chloride solution
1 mL microspheres: 7 mLYesYes
B207S1202 mL microspheres: 7 mL
Product
CodeCalibrated
size (µm)Size Range
(μm)QuantityIndication
Hypervascular
Tumors /
Arteriovenous
MalformationsUterine
Fibroid
B306S1200.9% sodium chloride solution
3 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0071 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S0077070-1002 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
C306S0103 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0101 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S01010075-1252 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
C306S0103 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0251 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S025250200-3002 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
C306S0253 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0401 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S040400350-4502 mL microspheres: 7 mL
0.9% sodium chloride solutionYesNo
C306S0403 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0501 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S050500480-5802 mL microspheres: 7 mL
0.9% sodium chloride solutionYesYes
C306S0503 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S0701 mL microspheres: 7 mL
0.9% sodium chloride solution
Product
CodeCalibrated
size (µm)Size Range
(µm)QuantityIndication
Hypervascular
Tumors /
Arteriovenous
MalformationsUterine
Fibroid
C107S0900.9% sodium chloride solution
1 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S090900825-9752 mL microspheres: 7 mL
0.9% sodium chloride solutionYesYes
C306S0903 mL microspheres: 6 mL
0.9% sodium chloride solution
C107S1201 mL microspheres: 7 mL
0.9% sodium chloride solution
C207S1201,2001,000-
1,2002 mL microspheres: 7 mL
0.9% sodium chloride solutionYesYes
C306S1203 mL microspheres: 6 mL
0.9% sodium chloride solution

Table 1: Device configurations of HRSpheres Embolic Microspheres

5

6

3 mL microspheres: 6 mL

2 mL microspheres: 7 mL

0.9% sodium chloride solution

Yes

Yes

700

C207S070

C306S070

650-750

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5. Indications for Use

HRSpheres Narrow-Size Embolic Microspheres are intended to be used for the embolization of arteriovenous malformations (AVMs) and hypervascular tumors, including uterine fibroids.

6. Comparison of Technological Characteristics with the Predicate Device

A comparison of the technological characteristics of HRSpheres and the CalliSpheres and 8Spheres embolic beads is summarized in Table 2 below:

Performance Characteristics Comparison Table
Device
CharacteristicSubject Device:
HRSpheres Narrow-Size
Embolic MicrospheresPredicate Device:
CalliSpheres and
8Spheres Embolic
MicrospheresComment
510(k) NumberK210562K173871N/A
ClassificationIIIISame
Product CodeKRD, NAJKRD, NAJSame
Performance Characteristics Comparison Table
Device
CharacteristicSubject Device:
HRSpheres Narrow-Size
Embolic MicrospheresPredicate Device:
CalliSpheres and
8Spheres Embolic
MicrospheresComment
Regulation21 CFR 870.330021 CFR 870.3300Same
Indication for
UseHRSpheres Narrow-Size
Embolic Microspheres are
intended to be used for the
embolization of
arteriovenous
malformations (AVMs)
and hypervascular tumors,
including uterine fibroids.CalliSpheres Embolic
Microspheres and
8Spheres Embolic
Microspheres are intended
to be used for the
embolization of
arteriovenous
malformations (AVMs)
and hypervascular tumors,
including uterine fibroids.Same
Polymerization
MethodSuspension
polymerizationSuspension
polymerizationSame
ResorptionNon-resorbableNon-resorbableSame
MaterialsPolyvinyl alcohol (PVA),
N-
acryloylaminoacetaldehyd
e dimethyl acetal, 2-
acrylamido-2-methyl-1-
propanesulfonic acid
sodium salt, 0.9% sodium
chloride solution, Reactive
Blue Dye #4 (only for
blue type microspheres)Polyvinyl alcohol (PVA),
N-
acryloylaminoacetaldehyd
e dimethyl acetal
(NAAADA), 2-
acrylamido-2-methyl-1-
propanesulfonic acid
sodium salt, 0.9% sodium
chloride solution, Reactive
Blue Dye #4 (only for
CalliSpheres)Different. The differences
in material do not raise
different questions of
safety and effectiveness.
Storage media0.9% sodium chloride
solution0.9% sodium chloride
solutionSame
Microsphere
DiameterSize range: 70-1,200μm
Labeled size range:
70-100 μm
75-125 μm
200-300 μm
350-450 μm
480-580 μm
650-750 μm
825-975 μm
1,000-1,200 μmSize range: 100-1,200μm
Labeled size range:
100-300μm
300-500μm
500-700μm
700-900μm
900-1,200μmDifferent. The subject
device contains a smaller
size range specification
than the predicate device.
The difference in size
ranges does not raise
different questions of
safety and effectiveness.
Performance Characteristics Comparison Table
Device
CharacteristicSubject Device:
HRSpheres Narrow-Size
Embolic MicrospheresPredicate Device:
CalliSpheres and
8Spheres Embolic
MicrospheresComment
Quantity of
Microspheres
(and storage
media)1 mL (in 7 mL saline), 2
mL (in 7 mL saline) or 3
mL (in 6 mL saline)1 mL (in 7 mL saline) or 2
mL (in 7 mL saline)Different. The difference
in microsphere volumes
does not raise different
questions of safety and
effectiveness.
PackagingSealed in borosilicate
glass vialSealed in borosilicate
glass vialSame
Compressibility50% by diameter30% by diameterDifferent. The subject
device is able to tolerate a
greater compressibility
than the predicate device.
The difference in
compressibility tolerance
does not raise different
questions of safety and
effectiveness.
Radiopacity
MethodMixed with non-ionic
contrast media prior to
injectionMixed with non-ionic
contrast media prior to
injectionSame
Delivery
MethodVia catheter under
fluoroscopic visualizationVia catheter under
fluoroscopic visualizationSame
Method of
SupplySterile and single useSterile and single useSame
Shelf LifeThree yearsTwo yearsDifferent. The increased
shelf life does raise
different questions of
safety and effectiveness.
SterilizationMoist heat and non-
pyrogenicMoist heat and non-
pyrogenicSame

Table 2: Technological Characteristic Comparison Table

8

9

Overall, the differences in technological characteristics between the subject and predicate device do not raise different questions of safety and effectiveness.

7. Summary of Non-clinical Performance Testing

The device is subject to Guidance for Industry and FDA Staff - Class II Special Controls Guidance Document: Vascular and Neurovascular Embolization Devices

10

issued on December 29, 2004. The safety and effectiveness of HRSpheres Narrow-Size Embolic Microspheres have been evaluated by non-clinical performance testing including:

In-Vitro Bench Testing 7.1

The test items, methods, and method references of HRSpheres Narrow-Size Embolic Microspheres are as follows:

Test ItemsTest MethodsResults
AppearanceUSP 39 - Injections and Implanted Drug
Products (Parenterals) -Product Quality Tests
and Visible Particulates In InjectionsMet predefined acceptance criteria
CompressibilityInternal MethodsMet predefined acceptance criteria
QuantityUSP PharmaceuticalMet predefined acceptance criteria
Size RangeInternal MethodsMet predefined acceptance criteria
SuspensionIn House MethodsMet predefined acceptance criteria
Catheter
DeliverabilityIn House MethodsMet predefined acceptance criteria
Water ContentUSP 39 NF34 (2016) - Loss on
dryingMet predefined acceptance criteria
pHUSP 39 NF 34 (2016) - pHMet predefined acceptance criteria
Impurities and
residual solventsUSP39 NF34 - Impurities in Drug
Substances and Drug ProductsMet predefined acceptance criteria
SterilityUSP Sterility TestsMet predefined acceptance criteria
Bacterial
endotoxinUSP Bacterial EndotoxinsMet predefined acceptance criteria

Table 3: Device Non-Clinical Performance Evaluations

7.2 Packaging Integrity and Shelf Life

HRSpheres Narrow-Size Embolic Microspheres are supplied sterile and packaged in borosilicate glass vials.

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According to ASTM F1980-16, accelerated aging tests equivalent to 3 years of shelf life were carried out on HRSpheres Narrow-Size Embolic Microspheres, with 3 batches of each tested for all device specifications. Accelerated aging tests for package integrity were also carried out on the packaging materials including the bottles, rubber closures, and aluminum plastic covers.

The results of the performance tests after accelerated aging demonstrated all samples met specifications. Therefore, the results support a 3 year shelf life of HRSpheres Narrow-Size Embolic Microspheres.

7.3 Sterilization and Shelf Life

HRSpheres Narrow-Size Embolic Microspheres are labeled as "Sterile" and "nonpyrogenic." HRSpheres Narrow-Size Embolic Microspheres are sterilized by moist heat sterilization with validated parameters (121 ℃, 30 min) after sealing the vials. Sterilization validation was completed to a sterility assurance level (SAL) of 10° using the Overkill Approach per ANSI/AAMI/ISO 17665-1:2006(R)2013.

HRSpheres Narrow-Size Embolic Microspheres were tested for bacterial endotoxins per USP Bacterial Endotoxins Test to a level of not more than 0.5 EU/mL in accordance with the requirements of FDA guidance document: Guidance for Industry: Pyrogen Endotoxins Testing: Questions and Answers, issued June 2012.

7.4 Chemical Characterization

Chemical characterization testing was conducted on HRSpheres Narrow-Size Embolic Microspheres. The testing consisted of exhaustive extraction of the microspheres in purified water, ethanol, and hexane. Extracts were analyzed per FTIR, GC-MS and UPLC-MS. Water extract was also analyzed by ICP-MS. A risk analysis using a worst-case risk assessment approach was conducted based upon the findings of the exhaustive extraction. Using this approach, it was determined that the margins of safety (MOS) for potential chemical exposures indicated a low risk of chronic toxicity and carcinogenicity.

7.5 Biocompatibility Evaluation

Biocompatibility testing was conducted in accordance with the 2020 FDA guidance document Use of International Standard ISO 10993-1, "Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process." The following biocompatibility tests listed in Table 3 were completed, and the results demonstrate the subject device is biocompatible:

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Biological EndpointTest MethodResults
MTT Cytotoxicity TestISO 10993-5:2009Non-cytotoxic
ISO Guinea Pig Maximization
Sensitization TestISO 10993-10:2010Non-sensitizer
ISO Intracutaneous Study in
RabbitsISO 10993-10:2010Non-irritant
ISO Acute Systemic Toxicity
Study in MiceISO 10993-11:2017No mortality or evidence of systemic
toxicity
ASTM Hemolysis StudyISO 10993-4:2017
ASTM F756:2017Non-hemolytic
ASTM Partial Thromboplastin
TimeASTM F2382:2018Non-activator
SC5b-9 Complement
Activation AssayISO 10993-4:2017Both the test article and the sponsor
provided control were considered to be
potential activators of the complement
system.
The test article was compared
statistically to the control and the test
article was lower than the control and
was statistically different.
USP Rabbit Pyrogen Study,
Material MediatedISO 10993-11:2017Non-pyrogenic
Genotoxicity Mouse
Lymphoma AssayISO 10993-3:2014Non-mutagenic
Bacterial Reverse Mutation
StudyISO 10993-3:2014Non-mutagenic
ISO Systemic Toxicity Study
in Rats Following
Subcutaneous Implantation,
13 WeeksISO 10993-6:2016
ISO 10993-11:2017There was no evidence of systemic
toxicity from the test article following
subcutaneous implantation in the rat.
Microscopically, the test article was
classified as causing minimal to no
reaction.
Biological EndpointTest MethodResults
ISO Muscle Implantation
Study in Rabbits, 4 WeeksISO 10993-6:2016The macroscopic reaction was not
significant as compared to the negative
control article.

Microscopically, the test article caused
a minimal to no reaction as compared
to the negative control article. |
| ISO Muscle Implantation
Study in Rabbits, 13 Weeks | ISO 10993-6:2016 | The macroscopic reaction was not
significant as compared to the negative
control article.

Microscopically, the test article caused
a slight reaction as compared to the
negative control article. |
| Chronic Systemic Toxicity
and Carcinogenicity
Evaluation | ISO 10993-1:2018
ISO 14971:2019
2020 FDA Biocompatibility
Guidance | A biological risk assessment was used
to support chronic systemic toxicity
and carcinogenicity endpoints. The
risk assessment was based on chemical
characterization results and supported
by information on the HRSpheres
materials of construction, gathered
toxicological data on these materials,
and biological data on the HRSpheres. |

Table 4: Device Biological Endpoints

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8. Animal Study Testing

An animal study was performed on the healthy swine models to evaluate the safety and effectiveness of the HRSpheres Narrow-Size Embolic Microspheres. A total of 15 female domestic swine were selected for evaluation. The animal study was intended to simulate the clinical application of the embolization microspheres by interventional procedure for partial renal artery embolization. Seven pigs were selected for embolization with the test article (75 - 125 um), and the other 8 pigs were selected for embolization with the control article (CalliSpheres Polyvinyl Alcohol Embolization Microspheres; K173871) (100 - 300 um). Several preoperative and postoperative observation time points were selected, including 3, 8 and 29 days after embolization.

At each observation time point, the changes of hematology, blood coagulation and serum biochemistry, as well as the imaging changes and pathological changes of kidney were detected, and the performance differences of test article and control were compared. The safety and effectiveness of HRSpheres Narrow-size embolic

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microspheres were comprehensively evaluated. These evaluations included the following:

    1. Comparison of recanalization of the vessels/durability of occlusion of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.
    1. Comparison of local and systemic foreign body reactions of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.
    1. Comparison of the ease of delivery of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.
    1. Comparison of the rupture or puncture of the blood vessels of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.
    1. Comparison of the non-target embolization/device migration of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.
    1. Comparison of local and systemic foreign body reactions of HRSpheres Narrow-size embolic microspheres and CalliSpheres Embolic Microspheres.

Animal evaluation indexes of HRSpheres Narrow-Size Embolic Microspheres on day 3, 8, and 29 were comparable to those from the control group. Tissue reactions of both test and control groups were found to be mild and comparable. Preoperative and postoperative clinicopathological examination results demonstrated that there was no significant difference between test group and control group with respect to adverse reactions. The results demonstrate that the subject device is as safe and effective as the cleared CalliSphere Embolic Microspheres (K173871).

9. Conclusion

As described above, the subject device has the same intended use as the predicate device. The differences in technological characteristics between the subject device and the predicate device do not raise different questions of safety and effectiveness. To evaluate the impact of the technological differences, performance testing was conducted as described above. The results of the testing demonstrate that the subject device, HRSpheres, is as safe and effective as the predicate device. Therefore, HRSpheres are substantially equivalent to the predicate.