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The Instylla Microcatheter is intended for use in small vessel or super selective anatomy for peripheral diagnostic and interventional procedures. The Instylla Microcatheter can be used for the infusion of diagnostic, embolic, or therapeutic materials into vessels.

The Instylla Microcatheter device is a single lumen, multipurpose catheter intended for use in the peripheral vasculature. The basic operating principle is to advance the microcatheter through an outer guiding catheter and track coaxially over a steerable guidewire in order to access the treatment site. The microcatheter lumen is able to accommodate steerable guidewires that are ≤ 0.014 in (0.36 mm) in diameter. Once the target region has been accessed, the microcatheter can be used to deliver diagnostic, embolic, or therapeutic materials into vessels.

The Instylla Microcatheter has a 1.7Fr (0.56mm) OD with a constant flexibility along its length. The ID of the microcatheter is 0.016 in (0.41mm) along its length. The proximal end of the microcatheter incorporates a standard luer hub to enable the attachment of accessories, and a strain relief with a feature that allow for flexibility and securement inside a Tuohy-Borst adapter, for maintaining position inside a guiding catheter as needed. The Instylla Microcatheter has a radiopaque marker at the distal tip to aid in fluoroscopic visualization. A 4Fr Tuohy-Borst with side-port adapter, a short catheter extension and a long catheter extension adapter are also included. The Instylla Microcatheter is available in 122, 142 and 162 cm usable lengths.

The provided text describes Instylla, Inc.'s K191731 510(k) submission for their Instylla Microcatheter. The document outlines the device's characteristics, its comparison to predicate devices, and the performance and safety studies conducted to demonstrate substantial equivalence.

Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text, while noting limitations in the information for certain requested points:

Acceptance Criteria and Device Performance for Instylla Microcatheter (K191731)

The acceptance criteria for the Instylla Microcatheter revolved around demonstrating substantial equivalence to a predicate device (CrossCath Support Catheter, K093052) through various performance benchmarks and safety assessments. Since this is a 510(k) submission, the "acceptance criteria" are implied by the comprehensive pre-clinical testing conducted to show that the device performs as safely and effectively as the predicate, and does not raise new questions of safety or effectiveness.

1. Table of Acceptance Criteria and Reported Device Performance

The text does not explicitly list numerical "acceptance criteria" values for each test, but it clearly states that the Instylla Microcatheter "met the predetermined acceptance criteria" for all tests and that "No new safety or performance issues were raised during testing."

Given the context of a 510(k), the implied acceptance criterion for each test is that the Instylla Microcatheter performs comparably to the predicate device or within recognized safety and effectiveness standards for such devices.

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The MAMBA™ and MAMBA™ Flex Microcatheters are intended to provide support to facilitate the placement of guidewires in the coronary vasculature, and can be used to exchange one guidewire for another.

The microcatheters are also intended to assist in the delivery of contrast media into the coronary vasculature.

The MAMBA™ and MAMBA™ Flex devices (referred to as the "MAMBA Microcatheters") are designed to provide a platform for the user to exchange guidewires without losing their position in the vasculature.

The MAMBA device is available in a 135cm length, while MAMBA Flex is available in 135cm and 150cm lengths.

The MAMBA Flex models have a smaller outer diameter and a more flexible distal portion than the MAMBA device.

Marks on the proximal portion of the catheter shaft and a radiopaque marker at the distal tip facilitate placement of the device.

The device's inner lumen permits the use of 0.014 in./0.36 mm or smaller quidewires. The shaft consists of a coil which allows the device to be torqued to assist in advancement. The distal portion of the shaft is coated hydrophilic coating to assist in advancement.

The proximal end has a single luer hub for flushing or injecting through the inner lumen and is for guide wire lumen access during a guidewire exchange.

The MAMBA Microcatheters are to be used in patients where vessel conditions require additional wire support to reach the lesion and will deliver radiopaque media and therapeutic agents to selected sites in coronary vasculature.

This document describes a 510(k) premarket notification for the MAMBA™ and MAMBA™ Flex Microcatheters. It asserts substantial equivalence to a predicate device, the ASAHI Corsair Microcatheter. The provided text primarily focuses on device description, indications for use, and a general statement about performance data, but does not contain the specific details required to answer many of the questions.

Here's an analysis of what can and cannot be answered based on the provided text:

Key Takeaway: The provided 510(k) summary is for a medical device (microcatheter), not an AI/Software as a Medical Device (SaMD). Therefore, the concept of "acceptance criteria" as applied to AI performance, "test sets," "ground truth establishment," "MRMC studies," or "standalone algorithm performance" (questions 1, 2, 3, 4, 5, 6, 7, 8, 9) does not directly apply in the context of this document.

The "Performance Data" section refers to bench, animal, and biocompatibility testing typical for a physical medical device. It states that "The results of these tests provide reasonable assurance that the proposed device has been designed and tested to assure conformance to the requirements for its intended use." However, it does not provide the specific numerical acceptance criteria or reported device performance in a table format that would be expected for an AI device.

Detailed Breakdown of Questions and Answers based on the provided text:

1. A table of acceptance criteria and the reported device performance

   • Cannot be provided. The document states that "Bench, animal and biocompatibility testing in accordance with ISO 10993 were performed to support a determination of substantial equivalence." It concludes that "No new safety or performance issues were raised during the testing; therefore, this device may be considered substantially equivalent to the predicate device." However, it does not present specific quantitative acceptance criteria or numerical reported performance data in a table format for a medical device like a microcatheter. The "acceptance criteria" for a physical device would relate to things like burst pressure, flow rate, tensile strength, kink resistance, etc., which are not detailed here.

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

   • Cannot be provided. This question is relevant to AI/SaMD. For a physical device, "sample size" would refer to the number of devices tested in bench or animal studies. While it states "Bench, animal and biocompatibility testing," it does not specify the sample sizes used for these tests or the "provenance" of such data (e.g., animal study location, if applicable).

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

   • Not applicable. This question is specific to AI/SaMD development, where expert consensus often establishes ground truth for image labeling or diagnosis. This document pertains to a physical medical device.

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

   • Not applicable. This question is specific to establishing ground truth with multiple readers for AI/SaMD development.

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. MRMC studies are used to evaluate the impact of AI assistance on human reader performance, typically in diagnostic imaging. This is a physical medical device.

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

   • Not applicable. This question refers to the performance of an AI algorithm on its own. This document is about a physical device.

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

   • Not applicable in the AI sense. For a physical device, "ground truth" would relate to objective measurements from bench testing (e.g., a force gauge measurement compared to a specification) or observations in animal studies (e.g., successful navigation, absence of vessel damage). The document only generally states that "Bench, animal and biocompatibility testing" were performed.

8. The sample size for the training set

   • Not applicable. "Training set" refers to data used to train an AI algorithm. This is a physical medical device.

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

   • Not applicable. Same reasoning as above.

Summary of what the document does provide:

• Device identification: MAMBA™ and MAMBA™ Flex Microcatheters.
• Classification: Class II, Percutaneous Catheter (DQY).
• Intended Use: Provide support for guidewire placement, facilitate guidewire exchange, assist in delivery of contrast media, and therapeutic agents in coronary vasculature.
• Predicate Device: ASAHI Corsair Microcatheter (K151103, K083127).
• Performance Data Overview: Mentions "Bench, animal and biocompatibility testing in accordance with ISO 10993" were performed. Concludes that no new safety or performance issues were raised and the device is substantially equivalent.
• Regulatory Outcome: FDA issued a substantial equivalence letter.

In conclusion, the provided text is a standard 510(k) summary for a physical medical device, not an AI/SaMD. As such, the detailed performance and validation data typically required for AI device assessment (as reflected in most of your questions) are not present or applicable.

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