K Number
K241478
Date Cleared
2024-10-22

(151 days)

Product Code
Regulation Number
870.1250
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Tri-Wedge PTA Scoring Balloon Dilatation Catheter is indicated to dilate stenoses in the illac, femoral, iliofemoral, popliteal, and renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

Device Description

The Tri-Wedge PTA Scoring Balloon Dilatation Catheter is an over-the-wire (OTW) peripheral balloon dilatation catheter. The catheter working length is 50cm, 75cm, 90cm and 150cm. Balloon diameters range from 3.0mm to 8.0mm. The balloon is made of a minimally compliant material with rated burst pressure of 20atm for Ø3.0-6.0mm and 16atm for Ø7.0-8.0mm. A coaxial double lumen catheter for balloon inflation and guide wire insertion is bonded to a female luer connector to form the proximal shaft. The balloon and the coaxial double lumen are welded to compose the distal of the catheter surface is coated with hydrophilic coating from the tip to the distal shaft. A scoring element with three parallel struts wraps around the balloon has radiopaque markers for positioning the balloon relative to the stenosis. The guide wire lumen is compatible with a standard 0.018-inch or 0.035-inch guide wire that enters from the catheter and extends out from the hub. The catheter is sterilized with EO and for single use only.

AI/ML Overview

The provided text describes a 510(k) summary for the Tri-Wedge PTA Scoring Balloon Dilatation Catheter, a medical device. This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than providing detailed clinical study results typical of drug approvals or novel device PMAs. The document focuses on bench testing and an animal study. Therefore, some of the requested information, particularly regarding human clinical trial data (e.g., sample size for test sets, number of experts for ground truth, MRMC studies, standalone performance, training set details for AI), is not applicable or available in this submission.

Here's a breakdown of the available information:

1. Table of Acceptance Criteria and Reported Device Performance

The submission states that "The test results met all acceptance criteria," but it does not provide a table detailing specific numerical acceptance criteria for each test and the corresponding reported device performance values. It only lists the types of tests performed.

2. Sample Size Used for the Test Set and Data Provenance

  • Test Set (Bench Testing): The document does not specify the exact sample sizes (N) for each individual bench test. It mentions that "Standard bench performance tests were conducted."
  • Test Set (Animal Study): The document refers to "the test group and the control group" in the animal study, but the specific sample size (number of animals) for each group is not provided.
  • Data Provenance: Not specified in the document. Likely refers to internal laboratory testing conducted by BrosMed Medical Co., Ltd.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications

Not applicable. The reported studies are bench tests and an animal study, which do not typically involve human expert adjudication for ground truth in the same way clinical trials for diagnostic devices do.

4. Adjudication Method for the Test Set

Not applicable for bench and animal studies.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size of Human Readers Improve with AI vs without AI Assistance

Not applicable. This device is a physical medical device (scoring balloon catheter), not an AI-powered diagnostic or assistive tool for human readers. Therefore, an MRMC study related to AI assistance is not relevant.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

Not applicable. This device is a physical medical device, not a software algorithm.

7. The Type of Ground Truth Used

  • Bench Testing: The "ground truth" would be established by the specifications and engineering requirements for the device. For example, a balloon's rated burst pressure is a predefined specification the device must meet.
  • Animal Study: The "ground truth" for the animal study (safety evaluation) was based on histological examination for inflammation, injury, and endothelialization scores, as well as observations of device performance (passage, dilation, withdrawal, coordination).

8. The Sample Size for the Training Set

Not applicable. This device does not involve a "training set" in the context of machine learning or AI.

9. How the Ground Truth for the Training Set Was Established

Not applicable.


Summary of Device Acceptance Criteria and Study Findings (Based on Provided Text):

The acceptance criteria for the Tri-Wedge PTA Scoring Balloon Dilatation Catheter were met through a series of bench tests and an animal study.

Test TypeAcceptance Criteria (General)Reported Device Performance
Bench TestingAdherence to FDA guidance "Peripheral Percutaneous Transluminal Angioplasty (PTA) and Specialty Catheters - Premarket Notification (510(k)) Submissions" and relevant ISO standards (e.g., ISO 10993-1). Device performance should be "same or similar to the predicate devices.""The test results met all acceptance criteria, were same or similar to the predicate devices, and ensure that the Tri-Wedge PTA Scoring Balloon Dilatation Catheter design and construction are suitable for its intended use. The results also demonstrate that no new questions of safety or effectiveness are raised."
Dimensions(Implied: Within specified ranges)Met
Simulated Use(Implied: Successful functionality)Met
Balloon Rated Burst Pressure(Implied: Meets specified pressure 16-20 atm)Met
Balloon Fatigue & Compliance(Implied: Meets durability and flexibility standards)Met
Balloon Inflation and Deflation Time(Implied: Within acceptable timeframes)Met
Catheter Bond Strength(Implied: Sufficient strength)Met
Scoring Wire Bond Strength(Implied: Sufficient strength)Met
Tip Pull Strength(Implied: Sufficient strength)Met
Flexibility and Kinking(Implied: Maintains structural integrity and navigability)Met
Torque Strength(Implied: Sufficient resistance to torsion)Met
Radiopacity(Implied: Visible under fluoroscopy)Met
Scoring Performance(Implied: Effective scoring)Met
Coating Friction & Integrity(Implied: Reduced friction, durable coating)Met
Particulate Evaluation(Implied: Within acceptable limits)Met
Catheter Body Burst Pressure(Implied: Sufficient pressure resistance)Met
Biocompatibility TestingIn accordance with "ISO 10993-1, Biological Evaluation of Medical Devices" for Cytotoxicity, Sensitization, Intracutaneous Reactivity, Systemic Toxicity, Hemocompatibility (Hemolysis, Thrombosis, Complement Activation), and Pyrogenicity.Met
Sterilization, Packaging, Shelf Life(Implied: Maintained sterility and integrity over lifetime)Met
Animal StudySafety of the device with no significant difference in performance or histopathological findings compared to a control group."No significant difference between the test group and the control group in the performance of device passage, dilatation, withdrawal and coordination. Histopathological examination showed no difference between the test group and the control group in terms of inflammation score, injury score and endothelialization score."

Conclusion from the document: The studies demonstrated that the Tri-Wedge PTA Scoring Balloon Dilatation Catheter met all acceptance criteria, showing substantial equivalence to the predicate device and raising no new questions of safety or effectiveness.

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Image /page/0/Picture/0 description: The image shows 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 is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

October 22, 2024

BrosMed Medical Co., Ltd. Crystal Lee Registration Affairs Senior Manager 15th Building. SMEs Venture Park SongShan Lake Hi-Tech Industrial Development Zone Dongguan, Guangdong 523808 China

Re: K241478

Trade/Device Name: Tri-Wedge PTA Scoring Balloon Dilatation Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: PNO Dated: May 23, 2024 Received: May 24, 2024

Dear Crystal Lee:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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).

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Sincerely,

Gregory W. Digitally signed by
Gregory W. Gregory W. O'connell -S O'connell -S Pate: 2024.10.22
11:48:18 -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

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Indications for Use

Submission Number (if known)

K241478

Device Name

Tri-Wedge PTA Scoring Balloon Dilatation Catheter

Indications for Use (Describe)

Tri-Wedge PTA Scoring Balloon Dilatation Catheter is indicated to dilate stenoses in the illac, femoral, iliofemoral, popliteal, and renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

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

1. GENERAL INFORMATION

1.1 Submitter

BrosMed Medical Co., Ltd. 15th Buildings, SMEs Venture Park SongShan Lake Hi-Tech Industrial Development Zone Dongguan 523808, China Office: +86 (769) 2289 2018 Fax: +86 (769) 2289 2016

1.2 Contract person

Crystal Lee, Email: crystallee@brosmed.com Office: +86 (769) 2289 2018

  • 1.3 Date of Preparation October 22, 2024

2. NAME OF THE DEVICE

  • 2.1.1 Trade/Proprietary Name Tri-Wedge PTA Scoring Balloon Dilatation Catheter
  • Submission 510(k) number 2.1.2 K241478

2.1.3 Common/Usual Name Percutaneous Transluminal Angioplasty (PTA) Scoring Catheter

2.1.4 Classification Information
Classification Name:Catheters, Peripheral, Cutting/Scoring
Classification Regulation:21 CFR 870.1250
Device Class:Class II (Special Controls)
Product Code:PNO
Review Panel:Cardiovascular

PREDICATE DEVICE AND REFERENCE DEVICES 3.

  • . Primary Predicate Device: AngioSculpt PTA Scoring Balloon Catheter (K150634, cleared on May 31, 2016)
  • Reference Device: UltraScore Focused Force PTA Balloon (K172571, cleared on September 22, 2017)

DESCRIPTION OF THE DEVICE 4.

The Tri-Wedge PTA Scoring Balloon Dilatation Catheter is an over-the-wire (OTW) peripheral balloon dilatation catheter. The catheter working length is 50cm, 75cm, 90cm and 150cm. Balloon diameters range from 3.0mm to 8.0mm. The balloon is made of a minimally compliant material with rated burst pressure of 20atm for Ø3.0-6.0mm and 16atm for Ø7.0-8.0mm. A coaxial double lumen catheter for balloon inflation and guide wire insertion is bonded to a female luer connector to form the proximal shaft. The balloon and the coaxial double lumen are welded to compose the distal of the catheter

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surface is coated with hydrophilic coating from the tip to the distal shaft. A scoring element with three parallel struts wraps around the balloon has radiopaque markers for positioning the balloon relative to the stenosis. The guide wire lumen is compatible with a standard 0.018-inch or 0.035-inch guide wire that enters from the catheter and extends out from the hub. The catheter is sterilized with EO and for single use only.

INDICATION FOR USE ട്.

The indication for use / intended use statement for the Tri-Wedge PTA Scoring Balloon Dilatation Catheter is as follows:

  • . The balloon dilatation catheter is indicated to dilate stenoses in the iliac, femoral, iliofemoral, popliteal, infrapopliteal, and renal arteries, and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.

INTENDED USE COMPARISION SUMMARY 6.

The subject device and the predicate devices, are intended to be used in identical interventional procedures within the same peripheral vasculature, serving the same fundamental purposes. Therefore, they can be considered substantially equivalent in terms of their intended use.

Element ofComparisonProposed devicePrimary Predicate deviceReference device
Product NameTri-WedgeAngioSculptUltraScore
Product CodePNOPNOPNO
RegulationNumber870.1250870.1250870.1250
Intended useThe Tri-Wedge PTAScoring Balloon DilatationCatheter is indicated todilate stenoses in the iliac,femoral, iliofemoral,popliteal, infrapopliteal,and renal arteries, and forthe treatment of obstructivelesions of native orsynthetic arteriovenousdialysis fistulae.The AngioSculpt PTAScoring Balloon Catheter isintended for dilatation oflesions in the iliac, femoral,ilio-femoral, popliteal, infra-popliteal, and renal arteries,and for the treatment ofobstructive lesions of nativeor synthetic arteriovenousdialysis fistulae. Not for usein the coronary or neuro-vasculature.The UltraScore Focused Force PTABalloon is intended to dilatestenoses in the iliac, femoral, ilio-femoral, popliteal, infra-poplitealand renal arteries and for thetreatment of obstructive lesions ofnative or synthetic arteriovenousdialysis fistulae. This device is alsorecommended for post dilatation ofballoon expandable stents, selfexpanding stents, and stent grafts inthe peripheral vasculature.

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7. TECHNOLOGICAL CHARACTERISTICS COMPARISION SUMMARY

The Subject device and Predicate devices are similar in terms of general design components, material and performance specifications. Please see below table for the technology comparison between Subject device and Predicate devices. The AngioScuplt was selected as the primary predicate because of the other similarities between the devices.

TechnologicalCharacteristicProposed DeviceTri-WedgePredicate DeviceAngioSculptUltraScoreComparison
General Catheter DesignConsists of tip, marker bands, balloon, scoring element, catheter shaft, strain relief, hub. Over-the-Wire (OTW) designConsists of tip, marker bands, balloon, scoring element, catheter shaft, strain relief, hub. Over-the-Wire (OTW) designSame
Shaft DesignDual lumen catheterDual lumen catheterSame
Compatible Guidewire (in)0.018, 0.0350.014, 0.0180.014, 0.035Same
Compatible Sheath (F)5, 6, 75, 64, 5, 6Different
Balloon Compliance TypeNon-CompliantNon-CompliantSame
Balloon Diameter Range(mm)3.0-8.02.0-8.02.0-8.0Same
Balloon Length Range(mm)20-6010-20020-300Same
Catheter Working Length(cm)50-15050-15540-150Same
Nominal Pressure (atm)126-86-8Different
Rated Burst Pressure (atm)16-2012-2010-14Different
Marker Band PresentYesYesYesSame
MaterialsProprietary Material InformationProprietary MaterialInformationDifferent
Sterilization MethodEthylene Oxide (EtO)Ethylene Oxide (EtO)Same

The differences between the proposed device and the predicate device have been thoroughly evaluated through the designed verification and validation tests as listed in below sections.

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8. PERFORMANCE TESTING SUMMARY

Standard bench performance tests were conducted to confirm substantial equivalence between the Subject Device and the Predicate Devices.

A Bench Testing

The in vitro performance tests were conducted on subject device in accordance with FDA guidance "Peripheral Percutaneous Transluminal Angioplasty (PTA) and Specialty Catheters - Premarket Notification (510(k)) Submissions, Guidance for Industry and FDA Staff ", including:

  • Dimensional verification
  • Simulated Use
  • Balloon Rated Burst Pressure ●
  • Balloon Fatigue & Compliance
  • Balloon Inflation and Deflation Time
  • Catheter Bond Strength
  • Scoring Wire Bond Strength ●
  • Tip Pull Strength
  • Flexibility and Kinking
  • Torque Strength
  • Radiopacity ●
  • Scoring Performance
  • Coating Friction & Integrity
  • Particulate Evaluation
  • Catheter Body Bust Pressure
  • Biocompatibility Testing

The biocompatibility testing, conducted in accordance with FDA guidance "Use of International Standard ISO 10993-1, Biological evaluation of medical devices - Part 1: Evaluation and testing within a risk management process", and International Standard "ISO 10993-1, Biological Evaluation of Medical Devices - Part 1: Evaluation and Testing Within a Risk Management Process", as recognized by FDA, included:

  • . Cytotoxicity
  • Sensitization
  • Intracutaneous Reactivity
  • Systemic Toxicity
  • Hemocompatibility
    • Hemolysis ●
    • Thrombosis ●
    • Complement Activation ●
  • Pyrogenicity ●
  • Sterilization Packaging and Shelf Life A

The test results met all acceptance criteria, were same or similar to the predicate devices, and ensure that the Tri-Wedge PTA Scoring Balloon Dilatation Catheter design and construction are suitable for its

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intended use. The results also demonstrate that no new questions of safety or effectiveness are raised by the proposed device.

A Animal Study

The animal study was conducted to evaluate the safety of Tri-Wedge PTA Balloon Dilatation Catheter. There was no significant difference between the test group and the control group in the performance of device passage, dilatation, withdrawal and coordination. Histopathological examination showed no difference between the test group and the control group in terms of inflammation score, injury score and endothelialization score.

9. CONCLUSION

Following the comprehensive comparison and analysis conducted, it has been determined that the proposed device does not present new or different questions regarding safety and effectiveness when compared to the predicate device. Consequently, the Tri-Wedge can be considered Substantially Equivalent (SE) to the marketed predicate devices.

§ 870.1250 Percutaneous catheter.

(a)
Identification. A percutaneous catheter is a device that is introduced into a vein or artery through the skin using a dilator and a sheath (introducer) or guide wire.(b)
Classification. Class II (performance standards).