Passeo-35 Xeo Peripheral Dilatation Catheter

K222065 · Biotronik, Inc. · LIT · Feb 16, 2023 · Cardiovascular

Device Facts

• Record ID: K222065
• Device Name: Passeo-35 Xeo Peripheral Dilatation Catheter
• Applicant: Biotronik, Inc.
• Product Code: LIT · Cardiovascular
• Decision Date: Feb 16, 2023
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 870.1250
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Passeo-35 Xeo peripheral dilatation catheter is intended for dilatation of stenotic segments in peripheral vessels and arteriovenous dialysis fistulae for the purpose of improving perfusion.

Device Story

Passeo-35 Xeo is an over-the-wire (OTW) dual-lumen balloon dilatation catheter used by physicians in clinical settings for peripheral angioplasty. The device features a balloon inflation/deflation lumen and a guide wire lumen (compatible with 0.035" guide wires). During procedures, the physician advances the catheter over a guide wire to the target lesion under fluoroscopic visualization. The balloon is inflated to dilate stenotic segments in peripheral arteries or arteriovenous dialysis fistulae, or to perform post-dilatation of stents. The device improves patient perfusion by restoring vessel patency. It is provided sterile via EO gas, with a 3-year shelf life.

Clinical Evidence

Bench testing only. No clinical data provided. Testing included design verification (balloon rated burst pressure, fatigue, flexibility, kink, torque, crossing profile, simulated use, tensile strength, retraction force, trackability, pushability), biocompatibility, sterilization, shelf life, and packaging validation. Results demonstrate the device meets specifications and performs equivalently to the predicate.

Technological Characteristics

Over-the-wire (OTW) dual-lumen balloon catheter. Materials include 90% Pt / 10% Ir radiopaque markers (1.5 mm). Compatible with 0.035" guide wires. Shaft diameter 5F. Balloon nominal pressure 7 atm; RBP varies by diameter (11-21 atm). Sterilization via EO gas (SAL 10^-6). Packaging includes HDPE protective sheath, Tyvek/PET/PE pouch, and cardboard carton.

Indications for Use

Indicated for patients requiring dilatation of stenosis in iliac, femoral, popliteal, and infrapopliteal arteries, and treatment of obstructive lesions in native or synthetic arteriovenous dialysis fistulae. Also recommended for post-dilatation of balloon-expandable and self-expanding stents in peripheral vasculature. Contraindicated in patients with lesions unreachable by the catheter, large amounts of acute/sub-acute thrombus, perforated vessels, lesions within/adjacent to aneurysms, uncorrected bleeding disorders, renal insufficiency, or contrast media allergy.

Regulatory Classification

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.

Predicate Devices

• BIOTRONIK Passeo-35 Percutaneous Transluminal Angioplasty (PTA) Catheter (K142379)

Submission Summary (Full Text)

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February 16, 2023

BioTronik, Inc. Jon Brumbaugh Vice President, Regulatory Affairs and New Product Development 6024 Jean Road Lake Oswego, Oregon 97035

Re: K222065

Trade/Device Name: Passeo-35 Xeo Peripheral Dilatation Catheter Regulation Number: 21 CFR 870.1250 Regulation Name: Percutaneous Catheter Regulatory Class: Class II Product Code: LIT Dated: January 9, 2023 Received: January 10, 2023

## Dear Jon Brumbaugh:

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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

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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 ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

Gregory W. Digitally signed by
Gregory W. Gregory W. O'connell -S O'connell -S 08:51:08-05'00'

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

510(k) Number (if known) K222065

Device Name Passeo-35 Xeo Peripheral Dilatation Catheter

Indications for Use (Describe)

The Passeo-35 Xeo peripheral dilatation catheter is indicated to dilate stenosis in the iliac, femoral, popliteal and infrapopliteal arteries and for the treatment of obstructive or synthetic arteriovenous dialysis fistulae. Passeo-35 is also recommended for post-dilatation of balloon expanding stents in the peripheral 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) |

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| 510(K) Summary: BIOTRONIK Passeo-35 Xeo Peripheral Dilatation Catheter | | | | | |
|------------------------------------------------------------------------|--|--|--|--|--|
| | | | | | |

| K222065) | |
|----------|--|
|----------|--|

| Date Prepared: | January 6, 2023 |
|-------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact: | Jon Brumbaugh<br>Vice President, Requlatory Affairs & New Product Development<br>BIOTRONIK, Inc.<br>6024 Jean Road<br>Lake Oswego, OR 97035 USA<br>Phone [phone]<br>Fax [phone]<br>Email: [e-mail] |
| Trade Name: | Passeo-35 Xeo Peripheral Dilatation Catheter |
| Generic/Common Name: | Percutaneous Catheter |
| Classification Name: | Catheter, Angioplasty, Peripheral, Transluminal |
| Classification & Panel: | Class II / 21 CFR § 870.1220, Cardiovascular |
| Product Code: | LIT |
| Predicate Device: | BIOTRONIK Passeo-35 Percutaneous Transluminal Angioplasty<br>(PTA)Catheter (K142379, cleared December 5, 2014) |

## Device Description

BIOTRONIK's Passeo 35 Xeo Catheter is an over-the-wire (OTW) balloon dilatation catheter, indicated for dilatation of stenotic segments in peripheral vessels. The Passeo 35 Xeo Catheter is a dual lumen design with both lumens contained within one tube. The smaller lumen is the balloon inflation/deflation lumen. The larger lumen permits the use of guide wires with a maximum diameter of 0.035″ to facilitate advancement of the Passeo 35 Xeo Catheter towards and through the lesion(s) to be dilated.

## Indications for Use

The Passeo-35 Xeo peripheral dilatation catheter is indicated to dilate stenosis in the illiac, femoral, popliteral and infrapopliteral arteries and for the treatment of obstructive lesions of native and synthetic arteriovenous dialysis fistulae.

Passeo-35 Xeo is also recommended for post-dilatation of balloon expandable and selfexpanding stents in the peripheral vasculature.

## Comparison of Technological Characteristics with the Predicate Devices

The BIOTRONIK Passeo-35 Xeo Peripheral Dilatation Catheter is substantially equivalent to the predicate device BIOTRONIK Passeo-35 Percutaneous Transluminal Angioplasty (PTA)Catheter (K142379, cleared December 5, 2014). The indications for use are similar,

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with only minor differences. The Passeo-35 Xeo and the predicate device have substantially equivalent safety and technological features as mentioned below.

The minor device design differences do not introduce new issues of safety or effectiveness as demonstrated by the Passeo-35 Xeo Peripheral Dilatation Catheter performance testing.

| | Comparison of Passeo-35 Xeo to Predicate Device Passeo-35 | | | |
|-----------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------|--|
| Characteristic | Predicate Device | Subject Device | Comparison | |
| Proprietary name | Passeo-35<br>(K142379) | Passeo-35 Xeo<br>(K222065) | New Name | |
| Common name | PTA catheter | | Unchanged | |
| Classification | Class II (21 CFR 870.1250) | | Unchanged | |
| Classification name | Catheter, angioplasty, peripheral, transluminal | | Unchanged | |
| Product code | LIT | | Unchanged | |
| Intended use | The Passeo-35 peripheral<br>dilatation catheter is intended<br>for dilatation of stenotic<br>segments in peripheral vessels<br>and arteriovenous dialysis<br>fistulae for the purpose of<br>improving perfusion. | The Passeo-35 Xeo peripheral<br>dilatation catheter is intended<br>for dilatation of stenotic<br>segments in peripheral vessels<br>and arteriovenous dialysis<br>fistulae for the purpose of<br>improving perfusion. | Updated to reflect<br>device name | |
| Indications for Use | The Passeo-35 peripheral<br>dilatation catheter is indicated<br>to dilate stenosis in the renal,<br>iliac, femoral, popliteal and infra<br>(popliteal arteries and for the<br>treatment of obstructive lesions<br>of native or synthetic<br>arteriovenous dialysis fistulae. | The Passeo-35 Xeo peripheral<br>dilatation catheter is indicated<br>to dilate stenosis in the iliac,<br>femoral, popliteal and<br>infrapopliteal arteries and for<br>the treatment of obstructive<br>lesions of native or synthetic<br>arteriovenous dialysis fistulae.<br>Passeo-35 is also recommended<br>for post-dilatation of balloon<br>expandable and self-expanding<br>stents in the peripheral<br>vasculature. | Comparable | |
| Contraindications | All general contraindications for<br>percutaneous transluminal<br>angioplasty (PTA) are<br>contraindications for this<br>device. Contraindications for<br>this device and peripheral<br>dilatation catheters in general<br>are:<br>• Lesions that cannot be<br>reached or treated with the<br>system<br>• Large amounts of acute or<br>subacute thrombus at the<br>target lesion<br>• Perforated vessels<br>• Lesion that lies within or<br>adjacent to an aneurysm<br>• Uncorrected bleeding<br>disorders<br>• Renal insufficiency or an<br>allergy to contrast media<br>Furthermore, all procedure-<br>related contraindications as | Passeo-35 Xeo is<br>contraindicated for use in<br>patients with:<br>• A lesion that cannot be<br>reached or treated with the<br>dilatation catheter.<br>• Large amounts of acute or<br>sub-acute thrombus at the<br>target lesion.<br>• Perforated vessels.<br>• A lesion that lies within or<br>adjacent to an aneurysm.<br>• Uncorrected bleeding<br>disorders.<br>• A renal insufficiency or an<br>allergy to contrast media.<br>Furthermore, all general PTA<br>and procedure-related<br>contraindications as described<br>in the national and international<br>guidelines of the respective<br>medical associations apply. | Comparable | |
| Comparison of Passeo-35 Xeo to Predicate Device Passeo-35 | | | | |
| Characteristic | Predicate Device | Subject Device | Comparison | |
| | described in the national and<br>international guidelines of the<br>respective medical associations<br>apply. | | | |
| Intended user | Physicians competent in PTA procedures | | Unchanged | |
| Method of<br>placement | Standard percutaneous access to site over a guide wire, with<br>fluoroscopic visualization | | Unchanged | |
| Sterilization / Shelf<br>Life / Packaging | 3 years | | Unchanged | |
| Sterilization | EO gas | | Unchanged | |
| SAL | 10-6 | | Unchanged | |
| Shelf life | 3 years | | Unchanged | |
| Protective sheath | Balloon has a HDPE protective sheath. HDPE spiral dispenser<br>sealed in a Tyvek® and PET/PE pouch.<br>Product is packed in an outer cardboard carton. | | Unchanged | |
| Device description | Over the wire 2-lumen balloon catheter | | Unchanged | |
| Radiopaque<br>markers | 2 markers– one at each end of the balloon<br>Material: 90% Pt / 10% Ir<br>Length: 1.5 mm | | Unchanged | |
| Usable length [cm] | 80, 90 and 130 | 90, 130, and 170 | Comparable | |
| Crossing profile | Ø: 3-7mm: max. 0.074 inches<br>Ø: 8-10mm: max. 0.083 inches | | Unchanged | |
| Guide wire<br>compatibility | 0.035" | | Unchanged | |
| Shaft outer<br>diameter [F] | 5 | | Unchanged | |
| Balloon diameter<br>[mm] | 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, 9.0,<br>10.0 | 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, 9.0,<br>10.0 and 12.0 | Comparable | |
| Balloon length<br>[mm] | 20, 40, 60, 80, 100, 120, 150,<br>170, 200 | 20, 40, 60, 80, 100, 120, 150,<br>170, 200 and 250 | Comparable | |
| Balloon wrapping | 5 folds | 3-5 folds | Comparable | |
| Balloon Nominal<br>pressure [atm] | 7 | | Unchanged | |
| Balloon RBP [atm] | 20 (Balloon Ø: 3mm)<br>18 (Balloon Ø: 4mm)<br>16 (Balloon Ø: 5 - 6 mm)<br>14 (Balloon Ø: 7 - 8 mm)<br>12 (Balloon Ø: 9mm)<br>11 (Balloon Ø: 10 mm) | 21 (Balloon Ø: 3mm)<br>18 (Balloon Ø: 4mm)<br>16 (Balloon Ø: 5 - 6 mm)<br>14 (Balloon Ø: 7 - 8 mm)<br>12 (Balloon Ø: 9mm)<br>11 (Balloon Ø: 10 mm) | Comparable | |

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# Performance Data

All necessary performance testing was conducted on the BIOTRONIK Passeo-35 Xeo Peripheral Dilatation Catheter to ensure that the device conforms to the design specification

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and to support a determination of substantial equivalence to the predicate device. The nonclinical bench testing included:

- Design Verification O
- Balloon Rated Burst Pressure
- Balloon Rated Burst Pressure in Stent ●
- Balloon Fatigue .
- Balloon Fatigue in Stent ●
- Flexibility and Kink Test
- Torque Strength
- Compatibility to Accessories
- Crossing Profile
- . Simulated Use
- Tensile strength
- Retraction Force ●
- . Trackability
- . Pushability
- Biocompatibility Testing O

In addition, BIOTRONIK has performed sterilization, shelf life and packaging validations. The collective results of the non-clinical testing demonstrate that the materials chosen, the manufacturing processes, and design of the Passeo-35 Xeo Catheters meet the established specifications necessary for consistent performance during its intended use. The collective bench testing demonstrates that the Passeo-35 Xeo Catheters do not introduce new issues of safety or effectiveness when compared to the predicate device.

## Conclusions

Based on the performance testing and the technological characteristics, it can be concluded that the BIOTRONIK Passeo-35 Xeo Peripheral Dilatation Catheter meets its established performance for its intended use and is substantially equivalent to the predicate device.