K Number
K230005
Device Name
Pantheris LV Atherectomy Catheter
Manufacturer
Date Cleared
2023-06-06

(154 days)

Product Code
Regulation Number
870.4875
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Pantheris LV System is indicated to remove plaque (atherectomy) from partially occluded native or restenotic vessels, including in-stent restenosis (ISR), in the peripheral vasculature with a reference diameter of 3.0 mm, using OCT-assisted orientation and imaging. The system is an adjunct to fluoroscopy by providing images of vessel lumen, wall structures, and vessel morphologies. The Pantheris LV System is NOT intended for use in the iliac, coronary, cerebral, renal or carotid vasculature.
Device Description
The Pantheris LV catheter combines the use of Avinger's optical coherence tomography (OCT) technology with peripheral vascular atherectomy capabilities. The Pantheris LV System consists of the Pantheris LV catheter, a Lightbox Sled with integrated umbilical (referred to as "Sled"), and the Lightbox Imaging Console (referred to as "Lightbox"). The Pantheris LV catheter is a 7 French device with a working length of 110 cm. It is comprised of two components-an outer support catheter and an inner assembly or drive shaft. It is provided sterile and is a single-use device compatible with 5 Fr vascular sheaths. The Pantheris LV catheter incorporates an optical fiber that allows real-time diagnosis of vessel condition and morphology as well as OCT-guided atherectomy during the procedure with its connection to the Lightbox.
More Information

No
The document describes a device that uses OCT imaging for guidance during atherectomy but does not mention any AI or ML components for image analysis, decision support, or other functions.

Yes.
The device itself is an atherectomy catheter, which is a medical device used to perform a therapeutic procedure (plaque removal).

Yes

Explanation: The "Device Description" states, "The Pantheris LV catheter incorporates an optical fiber that allows real-time diagnosis of vessel condition and morphology." This explicitly describes a diagnostic function.

No

The device description clearly outlines hardware components including a catheter, a Lightbox Sled, and a Lightbox Imaging Console.

Based on the provided information, the Pantheris LV System is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Pantheris LV System Function: The Pantheris LV System is a medical device used directly within the body (in vivo) to physically remove plaque from blood vessels. It uses OCT imaging to guide this procedure, but the imaging is for real-time visualization during the intervention, not for analyzing samples taken from the body.
  • Intended Use: The intended use clearly states it is for "remove plaque (atherectomy)" and is an "adjunct to fluoroscopy by providing images of vessel lumen, wall structures, and vessel morphologies." This describes a therapeutic and interventional procedure, not a diagnostic test performed on a sample.

Therefore, the Pantheris LV System falls under the category of an interventional medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Pantheris LV System is indicated to remove plaque (atherectomy) from partially occluded native or restenotic vessels, including in-stent restenosis (ISR), in the peripheral vasculature with a reference diameter of 3.0 mm, using OCT-assisted orientation and imaging. The system is an adjunct to fluoroscopy by providing images of vessel lumen, wall structures, and vessel morphologies. The Pantheris LV System is NOT intended for use in the iliac, coronary, cerebral, renal or carotid vasculature.

Product codes

MCW, NQQ

Device Description

The Pantheris LV catheter combines the use of Avinger's optical coherence tomography (OCT) technology with peripheral vascular atherectomy capabilities. The Pantheris LV System consists of the Pantheris LV catheter, a Lightbox Sled with integrated umbilical (referred to as "Sled"), and the Lightbox Imaging Console (referred to as "Lightbox").

The subject device of this submission is a product line extension of the Pantheris SV System reviewed and cleared earlier under K182341.

The Pantheris LV catheter is a 7 French device with a working length of 110 cm. It is comprised of two components-an outer support catheter and an inner assembly or drive shaft. It is provided sterile and is a single-use device compatible with 5 Fr vascular sheaths. The Pantheris LV catheter incorporates an optical fiber that allows real-time diagnosis of vessel condition and morphology as well as OCT-guided atherectomy during the procedure with its connection to the Lightbox.

The Pantheris LV catheter is to be used in a healthcare facility, such as a cardiac catheter lab or a hospital. It is to be used and in contact with patient tissue for less than 24 hours and is made of materials that are biocompatible.

This Traditional 510(k) builds on the Pantheris SV (K182341) and Pantheris v1.4 (K173862) atherectomy catheter designs and details additional minor modifications to the design of the Pantheris catheter family to add in functionality of the device.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Optical coherence tomography

Anatomical Site

Peripheral Vasculature

Indicated Patient Age Range

Not Found

Intended User / Care Setting

healthcare facility, such as a cardiac catheter lab or a hospital.

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

The performance testing conducted establishes that the Pantheris LV catheter did not raise new questions of the safety and effectiveness from those reviewed and cleared in the previous atherectomy catheter submissions K182341 and K173862.

Biocompatibility testing: The Pantheris LV catheter was assessed with the cytotoxicity test and found to be noncytotoxic.
Electrical safety and electromagnetic compatibility (EMC): The subject and predicate devices comply with IEC 60601-1 standard for safety and the IEC 60601-1-2 standard for EMC, as reviewed in K182341 (for the L250 console) and K212468 (for the L300 console).
Mechanical Testing:

  • Simulated use testing •
  • . Working length test
  • Catheter flush and leak test (following BS EN 1707:1997) .
  • OCT image generation and Sled interface test •
  • Catheter field of view test •
  • Distal tip rotation test .
  • Guidewire compatibility and insertion force test .
  • Catheter-Sheath insertion cycles test
  • Insertion force through the hub test
  • Retraction force through the hub test
  • . Insertion force over the arch test
  • Insertion force out of the sheath test .
  • Cutter exposure test .
  • OCT image generation and Sled interface test .
  • . Full 360° image test
  • Cut/Pack cycles test
  • Catheter Sled insertion cycles test ●
  • Packed position life cycle test .
  • Active position life cycle test ●
  • Torque shaft torque-proof loading test
  • Driveshaft torque-proof loading test ●
  • . Guidewire lumen peel strength-proof loading test
  • Proximal section torque shaft torque test .
  • Flush lumen luer tensile strength test (following ISO 10555-1:2013) ●
  • Distal catheter joints tensile strength test (following ISO 10555-1:2013)
  • Proximal catheter joints tensile strength test (following ISO 10555-1:2013). .
    Animal Testing: Preclinical (animal) testing of the subject device was not necessary. The testing that was completed was sufficient to demonstrate substantial equivalence of this model of Avinger's atherectomy catheters.
    Clinical Studies: Clinical testing of the subject device was not necessary. The testing that was completed was sufficient to demonstrate substantial equivalence of this model of Avinger's atherectomy catheters.

Key Metrics

Not Found

Predicate Device(s)

K182341

Reference Device(s)

K173862, K212047

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 870.4875 Intraluminal artery stripper.

(a)
Identification. An intraluminal artery stripper is a device used to perform an endarterectomy (removal of plaque deposits from arterisclerotic arteries.)(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/1 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, with the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

June 6, 2023

Avinger, Inc. Thomas Lawson VP, Clinical & Regulatory Affairs 400 Chesapeake Drive Redwood City, California 94063

Re: K230005

Trade/Device Name: Pantheris LV Atherectomy Catheter Regulation Number: 21 CFR 870.4875 Regulation Name: Intraluminal artery stripper Regulatory Class: Class II Product Code: MCW, NQQ Dated: May 2, 2023 Received: May 4, 2023

Dear Thomas Lawson:

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

1

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 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 (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 medical devices and radiation-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,

Image /page/1/Picture/5 description: The image shows a digital signature. The signature is for Eleni Whatley -S. The date of the signature is 2023.06.06. The time of the signature is 12:56:40 -04'00'.

Gregory O'Connell Assistant Director DHT2C: Division of Coronary and Peripheral Intervention Devices OHT2: Office of Cardiovascular Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K230005

Device Name

Pantheris LV Atheterctomy Catheter

Indications for Use (Describe)

The Pantheris LV System is indicated to remove plaque (atherectomy) from partially occluded native or restenotic vessels, including in-stent restenosis (ISR), in the peripheral vasculature with a reference diameter of 3.0 mm, using OCT-assisted orientation and imaging. The system is an adjunct to fluoroscopy by providing images of vessel lumen, wall structures, and vessel morphologies. The Pantheris LV System is NOT intended for use in the iliac, coronary, cerebral, renal or carotid vasculature.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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 the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) SUMMARY

General Information

SubmitterAvinger, Inc.
Address400 Chesapeake Drive
Redwood City, CA 94063
FDA Registration Number3007498664
Correspondence PersonThomas Lawson, PhD
VP, Clinical & Regulatory Affairs
Avinger Inc.
Contact InformationEmail: tlawson@avinger.com
Phone: 510-206-1794
Date Prepared5 June 2023

Proposed Device

Trade NamePantheris LV Atherectomy Catheter
Common NamePantheris LV
Regulation Number and
Classification Name21 CFR§870.4875, Intraluminal Artery Stripper
21 CFR§892.1560, Imaging System Optical Coherence
Tomography (OCT)
Product CodeMCW, NQQ
Regulatory ClassII
NOTE: This is the first 510(k) submission for this device.

Primary Predicate Device

Trade NamePantheris SV Atherectomy Catheter
Common NamePantheris
Premarket NotificationK201330
Regulation Number and
Classification Name21 CFR§870.4875, Intraluminal Artery Stripper
21 CFR§892.1560, Imaging System Optical Coherence
Tomography (OCT)
Product CodeMCW, NQQ
Regulatory ClassII
Note: This predicate device has not been subject to a design-related recall.

4

Trade NamePantheris Atherectomy Catheter
Common NamePantheris
Premarket NotificationK173862 & K212047
Regulation Number and
Classification Name21 CFR§870.4875, Intraluminal Artery Stripper
21 CFR§892.1560, Imaging System Optical Coherence
Tomography (OCT)
Product CodeMCW, NQQ
Regulatory ClassII
Note: This reference device has not been subject to a design-related recall.

Reference Device

Device Description and Proposed Modifications

The Pantheris LV catheter combines the use of Avinger's optical coherence tomography (OCT) technology with peripheral vascular atherectomy capabilities. The Pantheris LV System consists of the Pantheris LV catheter, a Lightbox Sled with integrated umbilical (referred to as "Sled"), and the Lightbox Imaging Console (referred to as "Lightbox").

The subject device of this submission is a product line extension of the Pantheris SV System reviewed and cleared earlier under K182341.

The Pantheris LV catheter is a 7 French device with a working length of 110 cm. It is comprised of two components-an outer support catheter and an inner assembly or drive shaft. It is provided sterile and is a single-use device compatible with 5 Fr vascular sheaths. The Pantheris LV catheter incorporates an optical fiber that allows real-time diagnosis of vessel condition and morphology as well as OCT-guided atherectomy during the procedure with its connection to the Lightbox.

The Pantheris LV catheter is to be used in a healthcare facility, such as a cardiac catheter lab or a hospital. It is to be used and in contact with patient tissue for less than 24 hours and is made of materials that are biocompatible.

This Traditional 510(k) builds on the Pantheris SV (K182341) and Pantheris v1.4 (K173862) atherectomy catheter designs and details additional minor modifications to the design of the Pantheris catheter family to add in functionality of the device.

5

Indications for Use

The indication for use for the Pantheris LV catheter is:

The Pantheris LV System is intended to remove plaque (atherectomy) from partially occluded native or restenotic vessels, including in-stent restenosis (ISR), in the peripheral vasculature with a reference diameter of 3.0 mm to 7.0 mm, using OCT-assisted orientation and imaging. The system is an adjunct to fluoroscopy by providing images of vessel lumen, wall structures, and vessel morphologies. The Pantheris LV System is NOT intended for use in the iliac, coronary, cerebral, renal or carotid vasculature.

Both the subject device and the reference device have the same intended use of debulking plaque in the lumen of peripheral arteries sized 3 to 7 mm in diameter. The subject device and predicate device are made from the same materials and use the same packaging.

Comparison of Technological Characteristics with the Predicate and Reference Devices

Avinger Inc. has identified the Pantheris SV catheter (K182341) as the predicate device and the Pantheris v1.4 (K173862) catheter as the reference device for the Pantheris LV catheter.

The Pantheris LV catheter is substantially equivalent to the predicate device with its design of a jog in the distal segment of the cannula that results in the cutter contacting target tissue as is the design of the Pantheris SV catheter. The Pantheris LV catheter is substantially equivalent to the Pantheris v1.4 catheter in its outer diameter (7 Fr) and indications of use in peripheral vessels 3 to 7 mm in diameter.

The Pantheris LV catheter is substantially equivalent to the predicate and reference devices in its clinical utility based upon the following factors:

  • The three devices are intended to be used to debulk lesions disrupting and restricting blood flow in peripheral vessels.
  • · The three devices are used in cardiac catheter labs in either a hospital or an office-based lab.
  • · The three devices are advanced to the target lesion through an indwelling vascular sheath.
  • · Advancement of the three devices is monitored by external fluoroscopy and the catheters' on-board intravascular OCT imaging component.
  • · The three devices consist of a rotating cutter that actively engages the plaque

6

tissue causing removal of the occlusive tissue and a power source to cause the device rotation of the cutter and display the OCT image during the procedure.

Comparison of the Pantheris LV catheter to the Pantheris SV catheter (predicate device), and the Pantheris v1.4 catheter (reference device).

| | Predicate Device
Pantheris SV System
(Avinger, Inc.) | Reference Device
Pantheris System
(Avinger, Inc.) | Subject Device
Pantheris LV System
(Avinger, Inc.) |
|-----------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------|
| | K182341 | K173862 &
K212047 | (This Submission) |
| Indication for
Use | The Pantheris SV catheter
is intended to remove
plaque (atherectomy)
from partially occluded
vessels in the peripheral
vasculature with a
reference diameter of 2.0
mm to 4.0 mm, using
OCT-assisted orientation
and imaging. The system
is an adjunct to
fluoroscopy by providing
images of vessel lumen,
wall structures and vessel
morphologies. The
Pantheris SV System is
NOT intended for use in
the iliac, coronary,
cerebral, renal or carotid
vasculature. | The Pantheris System
is intended to remove
plaque (atherectomy)
from partially
occluded native or
restenotic vessels,
including in-stent
restenosis (ISR), in
the peripheral
vasculature with a
reference diameter of
3.0 mm to 7.0 mm,
using OCT-assisted
orientation and
imaging. The system
is an adjunct to
fluoroscopy by
providing images of
vessel lumen, wall
structures and vessel
morphologies. The
Pantheris System is
NOT intended for use
in the iliac, coronary,
cerebral, renal or
carotid vasculature. | Identical to the
Pantheris v1.4
catheter |
| Intended use | Remove plaque
(atherectomy) from
partially occluded
peripheral arteries | Identical | Identical |
| Contraindications | The Pantheris SV System
is contraindicated for use
in the iliac, coronary, | Identical | Identical |
| | cerebral, renal or carotid
vasculature. | | |
| Product Code | MCW & NQQ | Identical | Identical |
| Treatment
Method | Debulking of plaque
within the lumen of
peripheral arteries | Identical | Identical |
| Technical
Characteristics | | | |
| Components of
the System | Catheter
Lightbox Imaging
Console
Sled | Identical | Identical |
| Imaging
Modality | Optical coherence
tomography | Identical | Identical |
| Imaging Energy
Type | Near-infrared Light | Identical | Identical |
| Optical Output
Power |