ASAHI GUIDE WIRE EXTENSION, MODEL AG149000

K083145 · Asahi Intecc Co., Ltd. · DQX · Jan 12, 2009 · Cardiovascular

Device Facts

• Record ID: K083145
• Device Name: ASAHI GUIDE WIRE EXTENSION, MODEL AG149000
• Applicant: Asahi Intecc Co., Ltd.
• Product Code: DQX · Cardiovascular
• Decision Date: Jan 12, 2009
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 870.1330
• Device Class: Class 2

Intended Use

The Asahi Guide Wire Extension accessory is intended for extension of the working length of an already introduced guide wire when exchanging over-the-wire interventional devices during an angioplasty procedure.

Device Story

The Asahi Guide Wire Extension is a stainless-steel accessory designed to elongate the working length of compatible Asahi PTCA and peripheral guide wires. It features a 0.014" (0.36mm) outer diameter, a 150cm length, and a distal preformed elastic connecting tube. The device is non-invasive and does not contact tissue or body fluids. It is used by clinicians during angioplasty procedures to facilitate the exchange of over-the-wire interventional devices. By extending the guide wire, the device allows for safer and more efficient device exchanges, potentially benefiting the patient by maintaining wire position during complex interventional steps.

Clinical Evidence

Bench testing only. No clinical data provided.

Technological Characteristics

Stainless-steel construction; 0.014" (0.36mm) outer diameter; 150cm length; distal preformed elastic connecting tube. Mechanical device; no energy source or software.

Indications for Use

Indicated for patients undergoing angioplasty procedures requiring the exchange of over-the-wire interventional devices where additional guide wire working length is necessary.

Regulatory Classification

Identification

A catheter guide wire is a coiled wire that is designed to fit inside a percutaneous catheter for the purpose of directing the catheter through a blood vessel.

Special Controls

*Classification.* Class II (special controls). The device, when it is a torque device that is manually operated, non-patient contacting, and intended to manipulate non-cerebral vascular guide wires, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 870.9.

Predicate Devices

• Asahi JoWire Neo's PTCA Guide Wire (K022762)
• Asahi Treasure 12 Peripheral Guide Wire (K061984)

Submission Summary (Full Text)

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# 510(K) SUMMARY

#### 510(K) Summary 9.0

# JAN 1 2 2009

x3145

This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

APPLICANT

ு.

Asahi Intecc Co., Ltd. 1703 Wakita-cho, Moriyama-ku Nagoya, Aichi 463-0024 Japan

OFFICIAL CORRESPONDENT Yoshi Terai President, CEO Asahi Intecc USA, Inc. 2500 Red Hill Avenue, Suite 210 Santa Ana, CA 92705 Tel: [phone] FAX [phone] e-mail: [e-mail]

TRADE NAME:

Asahi Guide Wire Extension (accessory)

COMMON NAME: Classification

NAME:

DEVICE

Wire, Guide, Catheter

Guide Wire Extension

Class 2 per 21 CFR §870.1330

CLASSIFICATION:

PRODUCT CODE DQX

PREDICATE DEVICE:

Asahi JoWire Neo's PTCA Guide Wire - K022762 Asahi Treasure 12 Peripheral Guide Wire - K061984.

# DESCRIPTION OF THE DEVICE SUBJECT TO PREMARKET NOTIFICATION:

The Asahi Guide Wire Extension accessory is used to elongate the working length of compatible Asahi PTCA and Peripheral extendable wires. The stainless-steel Asahi Guide Wire Extension has an outer diameter of 0.014" (0.36mm) and a length of 150cm. Its distal end bears preformed elastic connecting tube. The product is specially designed to use with Asahi PTCA and Peripheral extendable guide wires. This product is a non-invasive medical device, and it is not contact with tissue and body fluids.

000040

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### INDICATION FOR USE:

The Asahi Guide Wire Extension accessory is intended for extension of the working length of an already introduced guide wire when exchanging over-the-wire interventional devices during an angioplasty procedure.

### TECHNICAL CHARACTERISTICS:

The Asahi Guide Wire Extension accessory is made of the same materials that have been used in other predicate devices that are labeled for the similar indications. The dimensional specifications are equivalent to those listed for the currently cleared predicate devices.

## Performance Data:

Enclosed within this submission is performance data that demonstrates that the Asahi Guide Wire Extension accessory meets all predetermined performance criteria.

#### SUMMARY/CONCLUSION:

The Asahi Guide Wire Extension accessory characteristics are substantially equivalent to the specified predicate devices and other currently marketed devices for the same indication for use.

#### በሰብ በ / የ

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# DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, rendered in a stylized, minimalist design.

#### Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Asahi Intecc Co., Ltd. c/o Asahi Intecc USA, Inc. Mr. Yoshi Terai President, CEO 2500 Red Hill Ave, Suite 210 Santa Ana, CA 92705

Re: K083145

Trade/Device Name: Asahi Guide Wire Extension Common Name: Guide Wire Catheter Regulation Number: 21 CFR 870.1330 Regulatory Class: II Product Code: DQX Dated: December 12, 2008 Received: December 12, 2008

ﺎﺕ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟ

Dear Mr. Terai:

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.

JAN 1 2 2009

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.

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); good manufacturing practice requirements as set

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Page 2 - Mr. Yoshi Terai

forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate 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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometrics' (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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/industry/support/index.html.

Sincerely vours.

R. Vahner

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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#### 2.0 INDICATIONS FOR USE STATEMENT

510(k) Number (if known): 上の8ろしくら

Device Name: Asahi Guide Wire Extension

Indications for Use:

2.

The Asahi Guide Wire Extension accessory is intended for extension of the working length of an already introduced guide wire when exchanging over-the-wire interventional devices during an angioplasty procedure.

Prescription Use X

(Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use _ (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

R.Lachner

(Division Sign-Off) Division of Cardiovascular Devices

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510(k) Number_K083145