K Number
K211679
Device Name
Xtractor device
Date Cleared
2022-02-17

(261 days)

Product Code
Regulation Number
870.1310
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Xtractor™ device is intended for use in patients requiring the percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects.
Device Description
The Xtractor™ device is a single use sterilized device designed to be advanced through the veins over a cardiac pacemaker/defibrillator lead. The device is a motor driven mechanical tool that is introduced over the lead and follows its path, using a flexible and steerable shaft connected to a control handle. The proximal section of the shaft maintains pushability while the distal section is very flexible, to facilitate easy passage through vein curves and junctions. The device' distal tip is designed to facilitate dilation of fibrous binding tissue and passage through calcified binding sites along the implanted lead (for example by use of combined rotational and impact movements). The device' control handle, which is connected to the shaft, contains a steering mechanism for assisting the device maneuverability, and a motorized power transmission mechanism to activate the device tip. The Xtractor™ device is visible under fluoroscopy during the procedure.
More Information

No
The description focuses on mechanical and steerable components, with no mention of AI or ML terms or functionalities.

No
The device is used for mechanical dilation and removal of objects, not for treating a disease or condition itself.

No

The device is described as a "mechanical tool" for "percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects." Its function is to clear obstructions to allow removal, not to provide diagnostic information about a patient's condition or disease.

No

The device description clearly outlines a physical, mechanical tool with a motor, shaft, control handle, and tip designed for percutaneous dilation, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects." This is a therapeutic and interventional procedure performed directly on the patient's body.
  • Device Description: The description details a mechanical tool designed to be advanced through veins and used to dilate tissue and pass through binding sites. This is a physical intervention, not a test performed on a sample taken from the body.
  • Lack of IVD Characteristics: There is no mention of the device being used to analyze biological samples (blood, urine, tissue, etc.) or to provide diagnostic information about a patient's condition based on such analysis.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. The Xtractor™ device is a surgical/interventional tool used to perform a procedure within the body.

N/A

Intended Use / Indications for Use

The Xtractor™ device is intended for use in patients requiring the percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects.

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

DRE

Device Description

The Xtractor™ device is a single use sterilized device designed to be advanced through the veins over a cardiac pacemaker/defibrillator lead.

The device is a motor driven mechanical tool that is introduced over the lead and follows its path, using a flexible and steerable shaft connected to a control handle.

The proximal section of the shaft maintains pushability while the distal section is very flexible, to facilitate easy passage through vein curves and junctions. The device' distal tip is designed to facilitate dilation of fibrous binding tissue and passage through calcified binding sites along the implanted lead (for example by use of combined rotational and impact movements).

The device' control handle, which is connected to the shaft, contains a steering mechanism for assisting the device maneuverability, and a motorized power transmission mechanism to activate the device tip.

The Xtractor™ device is visible under fluoroscopy during the procedure.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

From pacemaker pocket, through the veins, along the path towards the heart

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Physicians knowledge in the techniques and devices for lead or catheter removal

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 performance data were provided in support of the substantial equivalence determination:

Biocompatibility evaluation in compliance with ISO 10993-1 was performed. The following tests were conducted: Cytotoxicity Study Xtractor™ -Device Cytotoxicity Study- Handle Cytotoxicity- pooling rod ISO Intracutaneous /irritation Study Sensitization Test Acute Systemic toxicity SC5b-9 Complement Activation Assay ASTM Hemolysis Pyrogen Study - Material Mediated ASTM Partial Thromboplastin Time with Sponsor Provided Control NAVI The device was found biocompatible.

Sterilization validation was performed to demonstrate compliance with ISO 11135-1. In addition, transportation simulation and environmental tests prior shelf life and packaging testing were performed to support the labeled shelf life. All tests were successfully completed.

Performance testing included the following:
Bending Test: The test was done to verify that the XtractorTM device is functional after working in an extreme bending radius.
Corrosion Resistance: Corrosion resistance was tested per ASTM A967/A967M
Device radiopacity: The test was done to verify that the XtractorTM device is visible under fluoroscopy.
Dimensional Verification: Measurements following sterilization of the XtractorTM device critical dimensions were taken.
Tensile strength: The test was done to define the tensile strength of the XtractorTM device and the External Sheath.
Extended use: Test was done to verify that the XtractorTM device is not damaged by the procedure and remains without signs of defects, wear or deformations in substantially extended and/or extreme use
Torque test: Torque transmission from the handle to the distal tip both inner and outer shaft was tested.
Simulated use: Simulated use of the device in anatomical model simulator was done in time T0 and time Tx (shelf life)
Hydrophilic coating testing: 3 tests (particles, visual, and pinch test) that demonstrated that the device coating performs as intended.
Xtractor™ vs. Predicate comparison test.

All tests passed and met the predefined acceptance criteria.

Software Validation: The Xtractor™ device level of concern is moderate. Software verification and validation testing were conducted, and documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices".

Electrical Safety and EMC: Electrical Safety per IEC 60601-1 and Electromagnetic compatibility (EMC) per IEC 60601-1-2 were conducted on the Xtractor™ Lead Extraction device.

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.

K140047

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.

K142546

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

§ 870.1310 Vessel dilator for percutaneous catheterization.

(a)
Identification. A vessel dilator for percutaneous catheterization is a device which is placed over the guide wire to enlarge the opening in the vessel, and which is then removed before sliding the catheter over the guide wire.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

February 17, 2022

Xcardia Innovation Ltd. % Orly Maor Regulatory Consultant 25 Sirkin Street Kfar Saba, 4442156 Israel

Re: K211679

Trade/Device Name: Xtractor device Regulation Number: 21 CFR 870.1310 Regulation Name: Vessel Dilator For Percutaneous Catheterization Regulatory Class: Class II Product Code: DRE Dated: January 17, 2022 Received: January 21, 2022

Dear Orly Maor:

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. You must comply with all the Act's

1

requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); 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-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) 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,

for

Hetal Odobasic Assistant Director Division of Cardiac Electrophysiology, Diagnostics and Monitoring Devices Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use Statement

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2023 See PRA Statement below.

K211679

Device Name Xtractor™ device

Indications for Use (Describe)

The Xtractor™ device is intended for use in patients requiring the percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects.

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

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)
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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including

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"An agency may not conductor sponsor, and a person is not required to respond to, a collection of

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FORM FDA 3881 (6/20)

PSC Publishing Services (301) 443-6740 ER

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Traditional Premarket Notification Submission - 510(k) Xtractor™ device 510(k) Number K211679

Date Prepared: February 15, 2022

I. SUBMITTER

Xcardia Innovation Ltd. 1 Hamada St. Rehovot 7670301, Israel E-mail: info@xcardia.com Tel: +97286321175

Contact Person

Orly Maor 25 Sirkin Street Kfar Saba 44421 Israel Tel: +972-9-7453607 oram.ma@gmail.com

II. DEVICE

Name of Device: Xtractor™ device Common or Usual Name: Xtractor™ device Classification Name: 21 CFR 870.1310; Vessel dilator for percutaneous catheterization Regulatory Class: II Product Code: DRE.

III. PREDICATE DEVICE

Xcardia Innovation Ltd. believes that the Xtractor™ device is substantially equivalent to the following predicate device:

  • Spectranetics TightRail™ Mechanical Dilator Sheath Set cleared under K140047 . (product code DRE Regulation No. 21 CFR 870.1310) and in subsequent submission under K142546 TightRail and TightRail Mini Rotating Dilator Sheaths.

DEVICE DESCRIPTION IV.

The Xtractor™ device is a single use sterilized device designed to be advanced through the veins over a cardiac pacemaker/defibrillator lead.

The device is a motor driven mechanical tool that is introduced over the lead and follows its path, using a flexible and steerable shaft connected to a control handle.

4

The proximal section of the shaft maintains pushability while the distal section is very flexible, to facilitate easy passage through vein curves and junctions. The device' distal tip is designed to facilitate dilation of fibrous binding tissue and passage through calcified binding sites along the implanted lead (for example by use of combined rotational and impact movements).

The device' control handle, which is connected to the shaft, contains a steering mechanism for assisting the device maneuverability, and a motorized power transmission mechanism to activate the device tip.

The Xtractor™ device is visible under fluoroscopy during the procedure.

V. INDICATIONS FOR USE

The Xtractor™ device is intended for use in patients requiring the percutaneous dilation of tissue to facilitate removal of cardiac leads, indwelling catheters, and foreign objects.

VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

The Xtractor™ device has the same intended use as the predicate device. Its indications for use are identical to that of the predicate device.

Xtractor™TightRail™SE JUSTIFICATION
510(k) NumberK211679K140047
ManufacturerXcardia Innovation Ltd.Spectranetics, Inc.
Product CodeDREDRESame
CFR21 CFR 870.131021 CFR 870.1310Same
Intended UseThe Xtractor™ device is
intended for use in patients
requiring the percutaneous
dilation of tissue to
facilitate removal of
cardiac leads, indwelling
catheters, and foreign
objects.The TightRail™ Rotating
Dilator Sheaths are
intended for use in
patients requiring the
percutaneous dilation of
tissue to facilitate
removal of cardiac leads,
indwelling catheters, and
foreign objects.Same
Nominal Outer
Diameter7.75mm6.6mm without sheath
and is designed to be used
with a 8.1mm sheathSimilar
The nominal outer
diameter is similar.
Xtractor™TightRail™SE JUSTIFICATION
Nominal Inner
Diameter13Fr9,11,13 FrSimilar
The nominal inner
diameter is similar.
Nominal
effective length540mm475mmSimilar
The nominal effective
length is similar.
Radiopacity
MarkersDevice: Radio-detectable
materials source is the dense
layers of stainless steel coils
Sheath: Radio-detectable
materials source is Teflon
compounded with 10-12%
bismuthDevice: Radio-detectable
materials source is the dense
layers of stainless steel coils
Sheath: Radio-detectable
materials source is Teflon
compounded with bismuth
trioxideSimilar
The radiopacity markers
are similar.
Blade designTwo circular rings: a rotating
blade for dilation, and a blunt
impact ring for axial
dilatationSerrated / Interrupted
Beveled Edge
Blade includes an axial
translation during rotation.Similar
Both designs are suitable
for dilation of
surrounding tissue.
Blade featureShielded
Blade is covered by the blunt
ring.Shielded
Blade is retracted into the
shaft.Similar.
Achieved by different but
substantially equivalent
mechanism.
MaterialsStainless Steel, Pebax Jacket
PTFE Teflon with bismuth for
radiopacity
Hydrophilic coatingStainless Steel, Pebax Jacket
PTFE Teflon with bismuth
trioxide for radiopacitySimilar
Shaft DesignShaft is designed to provide
a flexible means of aligning
the shaft and tip assembly
parallel to
the vessel wall in the
expected curvature of
the anatomy.Shaft is designed to
provide a flexible means
of aligning the shaft and
tip assembly parallel to the
vessel wall in the expected
curvature of the anatomy.Same
Xtractor™TightRail™SE JUSTIFICATION
Outer Sheath /
External Sheath
designOuter Sheath / Teflon (radio-
detectable)
Beveled distal end (to
navigate the expected
curvature of the anatomy)
The Xtractor™ external
sheath has flare proximal end
for convenient grip.
The Xtractor™ device (not
the sheath) already has a
blunt proximal end, thus
supports counter traction to
release of the lead from the
myocardiumOuter Sheath / Teflon
(radio-detectable)
Beveled distal (to
navigate the expected
curvature of the anatomy)
Blunt straight proximal
end when flipped around
(to provide a blunt surface
for counter-traction at the
release of the lead from the
myocardium)Both devices have same
purpose and similar
performance for
supporting the procedure
and entry into the vessel.
Anatomical Site
usedFrom pacemaker pocket,
through the veins, along the
path towards the heartFrom pacemaker pocket,
through the veins, along the
path towards the heartSame
Environments of
UsePhysicians knowledge in the
techniques and devices for
lead or catheter removalPhysicians knowledge in the
techniques and devices for
lead or catheter removalSame
SterilizationSterile for single use (EtO)Sterile for single use (EtO)Same
Device LifeDisposableDisposableSame
Prescription UseThe device should be used by
a physician who is familiar
with the intended procedures.The device should be used
by a physician who is
familiar with the intended
procedures.Same
OperationBattery operatedMechanicalTesting demonstrated
substantial equivalence
with respect to safe
operation
Haptic feelThe user advances the device
and pulls the lead manually.
The user activates the
motorized rotation of the shaft
using the handle's button or
pedal.The user advances the device
and pulls the lead manually.
The user rotates the shaft by
manual squeezing of the
                                                                                                                                                                                                                                 | The user advances the

device and pulls the lead
in exact same way.
Rotation is achieved by
different but substantially
equivalent mechanisms. |
| | Xtractor™ | TightRail™ | SE JUSTIFICATION |
| Mechanisms of
action/tissue
interaction | The Xtractor™ has a rotating
dilation blade that rotates to
assists the user in separating
the tissue that is bound around
the lead. The blade has sharp
teeth that when pushed
against the fibrotic tissue are
used to assist in separating it.
The Xtractor™ has a
"combined" mode | The TightRail™ device has a
rotating dilation blade that
rotates to assist the user in
separating the tissue that is
bound around the lead. The
blade has sharp teeth that
when pushed against the
fibrotic tissue are used to
assist in separating it.
The TightRail™ device is
actually working in a similar
"combined" mode. | The mechanism of action,
tissue interaction, and full
control by the user is
similar for both devices.
For the Extractor™, the
total amount of rotary
dilation is controlled by
the duration of button
press and in the predicate
device by number of
squeezes.
The Xtractor™ enables
the user to select modes
in which only sub-set of
the actions would be
performed.
The activation is fully
controlled by the user in
both devices.
The user can start and
stop the shaft rotation at
any time and change
mode as desired in the
Xtractor™. |
| Pedal | The Xtractor has a pedal that
includes the battery and
electrical circuitry to drive the
handle's motor, LED display
and buttons.
The pedal can be used to
select modes and for device
activation. | NA | The Xtractor™ pedal
provides battery power,
mode selection and for
convenient use by user.
The Xtractor™ can be
used to release the hand
of the user from manually
squeezing the trigger as
in the predicate device.
The activation is fully
controlled by the user in
both devices.
The user can start and
stop the shaft rotation at
any time and change
mode as desired in
Xtractor™.
Electrical safety, EMC
and software testing were |

The Xtractor™ device has similar technological characteristics as the predicate device as demonstrated in the table below:

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6

7

8

VII. PERFORMANCE DATA

The following performance data were provided in support of the substantial equivalence determination:

Biocompatibility -

Biocompatibility evaluation in compliance with ISO 10993-1 was performed. The following tests were conducted: Cytotoxicity Study Xtractor™ -Device Cytotoxicity Study- Handle Cytotoxicity- pooling rod ISO Intracutaneous /irritation Study Sensitization Test Acute Systemic toxicity SC5b-9 Complement Activation Assay ASTM Hemolysis Pyrogen Study - Material Mediated ASTM Partial Thromboplastin Time with Sponsor Provided Control NAVI The device was found biocompatible.

Sterilization, Packaging and Shelf Life Testing -

Sterilization validation was performed to demonstrate compliance with ISO 11135-1. In addition, transportation simulation and environmental tests prior shelf life and packaging testing were performed to support the labeled shelf life. All tests were successfully completed.

Performance Testing -

Performance testing included the following:

Name of testTest description
Bending TestThe test was done to verify that the XtractorTM device
is functional after working in an extreme bending
radius.
Corrosion ResistanceCorrosion resistance was tested per ASTM
A967/A967M
Device radiopacityThe test was done to verify that the XtractorTM device
is visible under fluoroscopy.
Dimensional VerificationMeasurements following sterilization of the
XtractorTM device critical dimensions were taken.
Tensile strengthThe test was done to define the tensile strength of the
XtractorTM device and the External Sheath.
Extended useTest was done to verify that the XtractorTM device is
not damaged by the procedure and remains without

9

Name of testTest description
signs of defects, wear or deformations in substantially
extended and/or extreme use
Torque testTorque transmission from the handle to the distal tip
both inner and outer shaft was tested.
Simulated useSimulated use of the device in anatomical model
simulator was done in time T0 and time Tx (shelf
life)
Hydrophilic coating testing3 tests (particles, visual, and pinch test) that
demonstrated that the device coating performs as
intended.
Xtractor™ vs. Predicate comparison
test

All tests passed and met the predefined acceptance criteria.

Software Validation -

The Xtractor™ device level of concern is moderate. Software verification and validation testing were conducted, and documentation was provided as recommended by FDA's Guidance for Industry and FDA Staff, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices".

-Electrical Safety and EMC

Electrical Safety per IEC 60601-1 and Electromagnetic compatibility (EMC) per IEC 60601-1-2 were conducted on the Xtractor™ Lead Extraction device.

VIII. CONCLUSION

The Xtractor™ device was determined to be substantially equivalent to the predicate devices.