K Number
K220699
Manufacturer
Date Cleared
2022-04-08

(29 days)

Product Code
Regulation Number
870.3300
Panel
CV
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Prestige Coil System is indicated for arterial and venous embolizations in the peripheral vasculature.

Device Description

The Prestige Coil System is a series of specialized coils that are inserted into the vasculature under angiographic visualization to embolize peripheral vascular anomalies. The system consists of an embolization coil implant comprised of platinum/tungsten, affixed to a delivery pusher to facilitate insertion into the hub of a microcatheter. The system is available in various shapes, lengths, and sizes. The devices are to be placed into anomalies to create blood stasis, reducing flow in the target vasculature, and inducing thrombosis. Upon positioning coils into the vasculature, the coils are thermally detached from the delivery pusher in serial manner until the target vasculature is occluded.

AI/ML Overview

The provided text is a 510(k) summary for the Prestige Coil System, a vascular embolization device, which explicitly states that it is not an AI/ML powered device. Therefore, it does not involve any of the AI/ML related concepts you asked about, such as training sets, test sets, ground truth establishment, MRMC comparative effectiveness studies, or AI performance metrics.

However, I can still extract the acceptance criteria and information about the studies performed for this non-AI medical device.

1. Table of Acceptance Criteria and Reported Device Performance

TestAcceptance CriteriaReported Performance
BiocompatibilityThe samples shall be biocompatible for their intended use based on the requirements of ISO 10993-1.Pass
Shelf LifeThe samples shall meet established acceptance criteria based on device specifications after simulated aging and transportation/distribution simulation.Pass
PackagingThe samples shall meet established acceptance criteria for packaging performance.Pass
Gamma SterilizationThe samples shall meet established acceptance criteria for sterility.Pass
CorrosionThe samples shall meet established acceptance criteria for corrosion.Pass
Detachment Zone TensileThe samples shall meet established acceptance criteria for tensile strength.Pass
Visual and Dimensional InspectionThe samples shall meet established acceptance criteria for visual physical damage and secondary diameter and length.Pass
Simulated UseThe samples shall be prepared in accordance with the instructions for use and meet established acceptance criteria for device performance in a clinically relevant model.Pass
Stretch-Resistance Thread Tensile TestingThe samples shall meet established acceptance criteria for tensile strength.Pass
Usability ValidationThe devices shall be prepared in accordance with their respective instructions for use and meet established acceptance criteria for device performance in a clinically relevant model. The labeling shall be clear and understandable by the intended user.Pass

2. Sample size used for the test set and the data provenance

As this is a non-AI/ML device, the concept of a "test set" in the context of AI does not directly apply. The studies mentioned are bench tests and non-clinical device assessments. Specific sample sizes for each test are not provided in this summary. The data provenance is from non-clinical bench testing performed by the manufacturer (Balt USA, LLC) to demonstrate substantial equivalence to a predicate device.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

Not applicable, as this is not an AI/ML device and does not involve establishing ground truth through expert review for a test set.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable, as this is not an AI/ML device and does not involve adjudication of expert assessments for a test set.

5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable, as this is not an AI/ML device and does not involve human readers or AI assistance.

6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done

Not applicable, as this is not an AI/ML device and does not have an algorithm to be evaluated in standalone mode.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

Not applicable, as this is not an AI/ML device. The "ground truth" for the device's performance in these non-clinical tests is based on pre-defined acceptance criteria derived from device specifications and recognized standards (e.g., ISO 10993-1).

8. The sample size for the training set

Not applicable, as this is not an AI/ML device and therefore no training set was used.

9. How the ground truth for the training set was established

Not applicable, as this is not an AI/ML device and therefore no training set was used or ground truth established for it.

§ 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).