GELWEAVE ANTE-FLO WITH COLLAR AND GELWEAVE 4 BRANCH PLEXUS WITH COLLAR

K040829 · Vascutek, Ltd. · DSY · May 20, 2004 · Cardiovascular

Device Facts

• Record ID: K040829
• Device Name: GELWEAVE ANTE-FLO WITH COLLAR AND GELWEAVE 4 BRANCH PLEXUS WITH COLLAR
• Applicant: Vascutek, Ltd.
• Product Code: DSY · Cardiovascular
• Decision Date: May 20, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.3450
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

REPAIR OR REPLACEMENT OF DAMAGED AND DISEASED VESSELS OF THE THORACIC AORTA IN CASES OF ANEURYSM, DISSECTION OR COARCTATION.

Device Story

Gelweave Ante-Flo and Gelweave 4 Branch Plexus with Collar are vascular graft prostheses. Used for surgical repair or replacement of thoracic aorta vessels affected by aneurysm, dissection, or coarctation. Implanted by surgeons in clinical/OR settings. Devices function as structural replacements for diseased vascular tissue. Benefit includes restoration of aortic blood flow and structural integrity.

Clinical Evidence

No clinical data provided; substantial equivalence based on device classification and intended use.

Technological Characteristics

Vascular graft prosthesis; 21 CFR 870.3460; Class II; Product Code DSY. Device includes collar for surgical attachment.

Indications for Use

Indicated for patients requiring repair or replacement of damaged or diseased thoracic aorta vessels due to aneurysm, dissection, or coarctation.

Regulatory Classification

Identification

A vascular graft prosthesis is an implanted device intended to repair, replace, or bypass sections of native or artificial vessels, excluding coronary or cerebral vasculature, and to provide vascular access. It is commonly constructed of materials such as polyethylene terephthalate and polytetrafluoroethylene, and it may be coated with a biological coating, such as albumin or collagen, or a synthetic coating, such as silicone. The graft structure itself is not made of materials of animal origin, including human umbilical cords.

Special Controls

*Classification.* Class II (special controls). The special control for this device is the FDA guidance document entitled “Guidance Document for Vascular Prostheses 510(k) Submissions.”

Submission Summary (Full Text)

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Public Health Service

Image /page/0/Picture/2 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 2 0 2004

Mr. Steven Arick Regulatory Affairs Manager Terumo Cardiovascular Systems Corporation US Headquarters 6200 Jackson Road Ann Arbor, MI 48103-9300

Re: K040829

Gelweave™ Ante-Flo and Gelweave™ 4 Branch Plexus with Collar Regulation Number: 21 CFR 870.3460 Regulation Name: Vascular Graft Prosthesis of 6mm and Greater Diameter Regulatory Class: Class II (two) Product Code: DSY Dated: March 26, 2004 Received: March 31, 2004

## Dear Mr. Arick:

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. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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.

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Page 2 - Mr. Steven Arick

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 that I Drideral statutes and regulations administered by other Federal agencies. You must or any 1 with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set Of It in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic forth in the quart) Byevelsions (Sections 531-542 of the Act); 21 CFR 1000-1050. product in allow you to begin marketing your device as described in your Section 510(k) rms lotter with and work your e FDA finding of substantial equivalence of your device to a legally premance noticated device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely vours,

Dina R. Vachnel

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## Indications for Use

510(k) Number (if known):

кучовая

Device Name:

VASCUTEK GELWEAVE WITH COLLAR -VASCULAR BRANCHED AND ANTE-FLO GRAFTS

Indications For Use:

REPAIR OR REPLACEMENT OF DAMAGED AND DISEASED VESSELS OF THE THORACIC AORTA IN CASES OF ANEURYSM, DISSECTION OR COARCTATION.

Prescription Use X

AND/OR

Over-The-Counter Use

(Part 21 CFR 801 Subpart D)

(21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Dinna R. Vachner

(Division Sign-Off) (Division Olgh of Cardiovascular Devices

510(k) Number k040829