The Auryon™ Atherectomy System and Auryon Atherectomy Catheters with aspiration are indicated for use as atherectorny devices for arterial stenoses, including in-stent restenosis (ISR), and to aspirate thrombus adjacent to stenoses in native and stented infra-inguinal arteries. The Auryon™ Atherectory System and Auryon Atherectomy Catheters without aspiration are indicated for use in the treatment, including atherectomy, of infra-inguinal stenoses and occlusions.
Device Story
Auryon Atherectomy System uses laser energy to treat arterial stenoses and occlusions. System consists of single-use catheters with optic fiber arrays and circumferential blunt blades at distal tips. Catheters connect to laser console, transmitting energy at 50 and 60 mJ/mm² to debulk lesions. Larger catheters (2.0mm, 2.35mm) include aspiration for debris/thrombus removal and eccentric guidewire lumens; 2.35mm model features 'off-center' capability for larger vessel debulking. Subject device adds hydrophilic coating to catheter shaft to reduce friction. Used in clinical settings by physicians; device tracks over 0.014" guidewires. Output is physical debulking of arterial plaque and thrombus aspiration, improving vessel patency. Benefits include minimally invasive treatment of peripheral artery disease and ISR.
Clinical Evidence
Bench testing only. Performance testing included catheter shaft dimensions, trackability in simulated anatomy, leakage testing (liquid/air), pull testing, optical functionality, and coating characterization (integrity and particulate generation). No clinical data presented.
Indicated for patients with infra-inguinal arterial stenoses and occlusions, including in-stent restenosis (ISR). Devices with aspiration are indicated for thrombus aspiration adjacent to stenoses in native and stented infra-inguinal arteries.
Regulatory Classification
Identification
An intraluminal artery stripper is a device used to perform an endarterectomy (removal of plaque deposits from arterisclerotic arteries.)
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September 26, 2022
Eximo Medical Ltd. c/o James Welsh Director, Regulatory Affairs AngioDynamics 603 Queensbury Ave Queensburgy, New York 12804
Re: K220116
Trade/Device Name: Auryon Atherectomy Catheters Regulation Number: 21 CFR 870.4875 Regulation Name: Intraluminal Artery Stripper Regulatory Class: Class II Product Code: MCW Dated: August 30, 2022 Received: August 30, 2022
Dear James Welsh:
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 statutes and regulations administered by other Federal agencies. You must comply with all the Act's
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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 (OS) 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 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).
Sincerely,
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
510(k) Number (if known) K220116
Device Name Auryon™ Atherectomy System
#### Indications for Use (Describe)
The Auryon™ Atherectomy System and Auryon Atherectomy Catheters with aspiration are indicated for use as atherectorny devices for arterial stenoses, including in-stent restenosis (ISR), and to aspirate thrombus adjacent to stenoses in native and stented infra-inguinal arteries.
The Auryon™ Atherectory System and Auryon Atherectomy Catheters without aspiration are indicated for use in the treatment, including atherectomy, of infra-inguinal stenoses and occlusions.
| Type of Use (Select one or both, as applicable) | |
|--------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------|
| <div> <span> <b> Prescription Use (Part 21 CFR 801 Subpart D) </b> </span> </div> | <div> <span> Over-The-Counter Use (21 CFR 801 Subpart C) </span> </div> |
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#### 510(k) Summary for the Eximo Medical Ltd. Auryon Atherectomy System
Date Prepared: September 22, 2022
#### Sponsor
Eximo Medical Ltd Pekeris St 3 Rehovot, Israel 7670203
# Contact
Yoel Zabar Sr. Director, R&D & Site Manager Eximo Medical Ltd. Telephone: +972-8-6307639 Email: yoelz@eximomedical.com
#### Subject Device
- 510(k) Reference Trade Name: Common Name: Regulation Number: Regulation Name: Regulatory Class: Product Code: Classification Panel:
#### Predicate Device
- 510(k) Reference Trade Name: Common Name: Regulation Number: Regulation Name: Regulatory Class: Product Code: Classification Panel:
Auryon™ Atherectomy System Peripheral Atherectomy Catheter 21CFR870.4875 Intraluminal Artery Stripper Class 2 MCW Cardiovascular Devices
## K202835
K220116
Auryon Atherectomy System Peripheral Atherectomy Catheter 21CFR870.4875 Intraluminal Artery Stripper Class 2 MCW Cardiovascular Devices
## Purpose
The purpose of this 510(k) is to introduce into commercial distribution four new catheter item codes for use with the existing Auryon Atherectomy System which will have a hydrophilic coating on the external distal portion of the catheter shaft. The size range, intended purpose, and Indications for Use will be the same as the existing Auryon Atherectomy Catheters.
## Device Description
The Auryon™ Atherectomy Catheters are single use catheters made of an array of optic fibers and surrounded by a circumferential blunt blade at its distal tip. The Auryon catheter is connected to the laser of the predicate device Auryon Atherectomy System via its connector and transmits energy at pre-set fluence levels of 50 and 60 ml/mm² to the occluded or narrowed artery. The Auryon™ Atherectomy Catheter must work over a commercially available 300cm 0.014" guide wire that crosses the lesion intra
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luminally. The new catheters which are the subject of this 510(k) include a hydrophilic coating on the external distal portion of the catheter shaft.
The predicate device Auryon Atherectomy Catheters are available in four sizes (0.9mm, 1.5mm, 2.0mm and 2.35mm, without hydrophilic coating. The subject device Auryon Atherectomy Catheters are available in the same four sizes (0.9mm, 1.5mm, 2.0mm and 2.35mm, but with a hydrophilic coating.
For the small size catheters (i.e., 0.9mm and 1.5mm), there is a designated lumen tube for a guidewire at the center of the inner blunt blade. The 0.9mm and 1.5mm catheters do not have an aspiration feature and have not been tested in ISR lesions.
The larger Auryon catheters (i.e., 2.0mm and 2.35mm) have an eccentric guidewire lumen, and include additional features consisting of an aspiration feature (both catheters) and an "off-center" feature 2.35mm only). The aspiration feature is intended for debris and thrombus collection and removal from the vessel during the atherectomy procedure. These devices are also indicated for treatment of In-Stent Restenosis (ISR) lesions.
The "off-center" feature is included in the 2.35 mm catheter only and is designed to facilitate debulking of lesions in blood vessels beyond the catheter's diameter.
# Indications for Use
The Auryon™ Atherectomy System and Auryon Atherectomy Catheters with aspiration are indicated for use as atherectomy devices for arterial stenoses, including in-stent restenosis (ISR), and to aspirate thrombus adjacent to stenoses in native and stented infra-inguinal arteries.
The Auryon™ Atherectomy System and Auryon Atherectomy Catheters without aspiration are indicated for use in the treatment, including atherectomy, of infra-inguinal stenoses and occlusions.
## Comparison of Similarities and Differences in Technological Characteristics and Performance
As detailed below, the proposed Auryon™ Atherectomy System is Substantially Equivalent to the predicate device Auryon Atherectomy system.
| Device<br>Comparison | Subject Device:<br>Auryon™<br>Atherectomy System<br>(with Hydrophilic<br>coating) | Predicate<br>Device: Auryon<br>Atherectomy<br>System<br>(K202835) | Reference Device:<br>Auryon™<br>Atherectomy System<br>(K221077) | Reference<br>Device:<br>Spectranetics<br>Turbo-Elite Laser<br>Atherectomy<br>Catheters<br>(K170059) |
|-------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indication for Use | The Auryon™<br>Atherectomy System<br>and Auryon<br>Atherectomy<br>Catheters with | The Auryon<br>Atherectomy<br>System is<br>intended for use<br>in the | The Auryon™<br>Atherectomy System<br>and Auryon<br>Atherectomy<br>Catheters with | The Turbo-Elite<br>devices are<br>indicated for use<br>in the treatment,<br>including |
| | aspiration are<br>indicated for use as<br>atherectomy devices<br>for arterial stenoses,<br>including in-stent<br>restenosis (ISR), and<br>to aspirate thrombus<br>adjacent to stenoses<br>in native and stented<br>intra-inguinal<br>arteries.<br>The Auryon™<br>Atherectomy System<br>and Auryon<br>Atherectomy<br>Catheters without<br>aspiration are<br>indicated for use in<br>the treatment,<br>including<br>atherectomy, of<br>intra-inguinal<br>stenoses and<br>occlusions. | treatment,<br>including<br>atherectomy, of<br>intra-inguinal<br>stenoses and<br>occlusions,<br>including in-<br>stent restenosis<br>(ISR). | aspiration are<br>indicated for use as<br>atherectomy devices<br>for arterial stenoses,<br>including in-stent<br>restenosis (ISR), and<br>to aspirate thrombus<br>adjacent to stenoses<br>in native and stented<br>intra-inguinal<br>arteries.<br>The Auryon™<br>Atherectomy System<br>and Auryon<br>Atherectomy<br>Catheters without<br>aspiration are<br>indicated for use in<br>the treatment,<br>including<br>atherectomy, of<br>intra-inguinal<br>stenoses and<br>occlusions. | atherectomy, of<br>infrainguinal<br>stenoses and<br>occlusions.<br>The 0.014" and<br>0.018" Over-the-<br>wire (OTW)<br>Turbo-Elite laser<br>catheters are also<br>indicated for use<br>as an accessory<br>to the use of the<br>Turbo-Tandem<br>System in the<br>treatment of<br>femoropopliteal<br>artery in-stent<br>restenosis (ISR) in<br>bare nitinol<br>stents, when<br>used in<br>conjunction with<br>Percutaneous<br>Transluminal<br>Angioplasty<br>(PTA). |
| Regulation<br>Number | 21 CFR §870.4875 | 21 CFR<br>§870.4875 | 21 CFR §870.4875 | 21 CFR<br>§870.4875 |
| Regulatory Class | Class II | Class II | Class II | Class II |
| Product Code | MCW | MCW | MCW | MCW |
| Catheter sizes | 0.9mm, 1.5mm,<br>2.0mm, 2.35mm | 0.9mm, 1.5mm,<br>2.0mm, 2.35mm | 0.9mm, 1.5mm,<br>2.0mm, 2.35mm | 0.9mm, 1.4mm<br>1.7mm, 2.0mm,<br>2.3mm, and<br>2.5mm |
| Hydrophilic<br>coating | Yes, all sizes | No | No | Yes, all sizes |
| Catheter<br>Sterilization<br>Method | Ethylene Oxide | Ethylene Oxide | Ethylene Oxide | Ethylene Oxide |
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# Comparison of Performance Data
The hydrophilic coated Auryon Atherectory Catheters were tested using the same methods and acceptance criteria as was done in the predicate device 510(k). In addition, coating performance was tested, with comparison to the performance of the reference device K170059. The specific tests are listed below
#### Summary of Performance Testing
Catheter shaft ID, OD, working length, and length of hydrophilic coating Catheter trackability in simulated anatomical shape Freedom from leakage during liquid infusion, and air leakage during aspiration (2.0 and 2.35mm sizes) Pull testing of catheter tip and catheter to handle joints Freedom from exposed optical fibers Catheter torque test Optical Functionality test Coating Characterization Coating integrity and particulate generation after simulated use
# Substantial Equivalence
Assessment of the similarities and differences of the proposed hydrophilic coated Auryon Atherectomy Catheters and the predicate Auryon Atherectomy System and the reference device Spectranetics Turbo-Elite Laser Atherectomy Catheters concludes that the devices are substantially equivalent to one another; specifically:
- . The proposed and predicate device have the identical ProCode, Regulation Number, Regulation Name, and Regulatory Class;
- The proposed and predicate devices have the same Intended Use;
- The proposed and reference device K221077 have the same Indications for Use;
- The proposed and predicate devices incorporate the identical operating principle, mechanism of action, and are intended for the same patient populations; and,
- The proposed and predicate catheters employ an identical overall design, essentially identical materials of manufacture, performance testing, sizes, and configurations.
- The proposed device and the reference device K170059 employ hydrophilic coatings that are similar in formulation, performance, and intended purpose (reduction of friction).
The sum of these evaluations and determinations lead Eximo Medical Ltd. to conclude that substantial equivalence has been demonstrated, and that the existing data, and additional testing, have confirmed that there are no new questions of safety or effectiveness.
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.