510(k) Report

510(k) · Cleared

Cleared

Alignment System Cranial, with Alignment Software Cranial with LITT; Cirq Alignment Software Cranial Biopsy; Cirq Alignment Software Cranial sEEG; VarioGuide Alignment Software Cranial; Cirq Alignment Software Cranial LITT

K243698510(k) TraditionalCleared Jan 28, 202560-day reviewClass II21 CFR 882.4560

Data to Oct 25, 2026 (FDA decisions) Oct 12, 2026 (recalls) Sep 30, 2026 (MAUDE) refreshed weekly, last Nov 3, 2026

Brainlab AG · HAW Neurological Stereotaxic Instrument

Cleared on Jan 28, 2025 as substantially equivalent to K191597 (Medtronic Navigation, Inc., 2019) and 1 other predicate after a 60-day review. Its family tree reaches back 13 generations to 1986. 3 of the 103 devices in its family, counting itself, have a Class I recall.

Decided
Jan 28, 2025
Review
60 days
Class
Class II
Product code
HAW
Recalls
None
Predicates
2

Its longest line of descent runs back 13 generations to K862807 (1986). 102 ancestors in all, the oldest K811452 (1981). No later device cites it as a predicate yet. 3 of the 103 devices in this family, counting this one, have a Class I recall.

Other ancestors, by year cleared 2020: 1 other ancestor2017: 1 other ancestor2015: 1 other ancestor, 1 with a Class I recall12010: 2 other ancestors, 1 with a Class I recall12009: 3 other ancestors2008: 2 other ancestors2007: 2 other ancestors, 1 with a Class I recall12002: 6 other ancestors2001: 5 other ancestors1987: 3 other ancestors2006: 5 other ancestors2004: 6 other ancestors2003: 4 other ancestors2000: 8 other ancestors1999: 3 other ancestors1995: 7 other ancestors1994: 4 other ancestors2005: 7 other ancestors1998: 4 other ancestors1997: 4 other ancestors1986: 1 other ancestor1996: 1 other ancestor1985: 1 other ancestor1981: 1 other ancestor1988: 2 other ancestors1992: 2 other ancestors1989: 1 other ancestor1990: 1 other ancestor1984: 1 other ancestorK862807 · Treace Drill System · Treace Medical, Inc. · 1986×2: 2 generations cleared close together, K964548 (1997), K971059 (1997) K981637 · Integrated Drive/Pump System for Otolaryngology · Linvatec Corp. · 1998K990524 · E9000 System · Linvatec Corp. · 1999K012456 · Sodem High Speed System (Electric) (Ear, Nose, and Throat) · Sodemsystems · 2001K081277 · XPS 4000 System, Midas Rex Legend Ehs System, Integrated Power CONS0LE (Ipc) · Medtronic Xomed, Inc. · 2008 · recalledK111520 · Ipc Powerease System · Medtronic Xomed, Inc. · 2011 · recalledK121264 · Triton Electric High Torque Handpiece and Software Module · Medtronic Surgical Technologies · 2012K170312 · IPC systems, Legend EHS handpieces and Legend Stylus Touch handpiece, Microsaw handpieces,Triton electric high torque handpiece, Attachments and surgical dissecting tools · Medtronic Powered Surgical Solutions · 2017K191597 · Stealth Autoguide System, Midas Rex Legend Depth Stop System · Medtronic Navigation, Inc. · 2019 · recalledK210989 · Cirq, Cirq Robotic Alignment System, Cirq Robotic Alignment Module Cranial, Cirq Robotic Alignment Module, Cirq Robotic Alignment Cranial And Spine, CIRQ Robotic Alignment Cranial and Spine System · Brainlab AG · 2021K223864 · Alignment System Cranial, Alignment Software Cranial, Cirq Alignment Software Cranial Biopsy, Cirq Alignment Software Cranial sEEG, Varioguide Alignment Software Cranial · Brainlab AG · 202319801990200020102020
Other ancestors, by generation 2 generations back: 3 other ancestors, 1 with a Class I recall13 generations back: 9 other ancestors, 2 with a Class I recall24 generations back: 12 other ancestors5 generations back: 18 other ancestors6 generations back: 19 other ancestors7 generations back: 16 other ancestors8 generations back: 7 other ancestors9 generations back: 1 other ancestor10 generations back: 4 other ancestors K223864 · Alignment System Cranial, Alignment Software Cranial, Cirq Alignment Software Cranial Biopsy, Cirq Alignment Software Cranial sEEG, Varioguide Alignment Software Cranial · Brainlab AG · 2023K210989 · Cirq, Cirq Robotic Alignment System, Cirq Robotic Alignment Module Cranial, Cirq Robotic Alignment Module, Cirq Robotic Alignment Cranial And Spine, CIRQ Robotic Alignment Cranial and Spine System · Brainlab AG · 2021K191597 · Stealth Autoguide System, Midas Rex Legend Depth Stop System · Medtronic Navigation, Inc. · 2019 · recalledK170312 · IPC systems, Legend EHS handpieces and Legend Stylus Touch handpiece, Microsaw handpieces,Triton electric high torque handpiece, Attachments and surgical dissecting tools · Medtronic Powered Surgical Solutions · 2017K121264 · Triton Electric High Torque Handpiece and Software Module · Medtronic Surgical Technologies · 2012K111520 · Ipc Powerease System · Medtronic Xomed, Inc. · 2011 · recalledK081277 · XPS 4000 System, Midas Rex Legend Ehs System, Integrated Power CONS0LE (Ipc) · Medtronic Xomed, Inc. · 2008 · recalledK012456 · Sodem High Speed System (Electric) (Ear, Nose, and Throat) · Sodemsystems · 2001K990524 · E9000 System · Linvatec Corp. · 1999K981637 · Integrated Drive/Pump System for Otolaryngology · Linvatec Corp. · 1998K971059 · Universal Drive System · Linvatec Corp. · 1997K964548 · Apex Universal Drive System · Linvatec Corp. · 1997K862807 · Treace Drill System · Treace Medical, Inc. · 1986−10−50
  1. Root · 13 generations backK862807 Treace Drill SystemTreace Medical, Inc. · 1986
  2. 9 generations between
  3. 3 generations backK191597 Stealth Autoguide System, Midas Rex Legend Depth Stop SystemMedtronic Navigation, Inc. · 2019 · Recalled
  4. 2 generations backK210989 Cirq, Cirq Robotic Alignment System, Cirq Robotic Alignment Module…Brainlab AG · 2021
  5. 1 generation backK223864 Alignment System Cranial, Alignment Software Cranial, Cirq Alignment…Brainlab AG · 2023
  6. This deviceK243698 Alignment System Cranial, with Alignment Software Cranial with LITT…Brainlab AG · 2025
Show all 13 generations
  1. Root · 13 generations backK862807 Treace Drill SystemTreace Medical, Inc. · 1986
  2. 12 generations backK964548 Apex Universal Drive SystemLinvatec Corp. · 1997
  3. 11 generations backK971059 Universal Drive SystemLinvatec Corp. · 1997
  4. 10 generations backK981637 Integrated Drive/Pump System for OtolaryngologyLinvatec Corp. · 1998
  5. 9 generations backK990524 E9000 SystemLinvatec Corp. · 1999
  6. 8 generations backK012456 Sodem High Speed System (Electric) (Ear, Nose, and Throat)Sodemsystems · 2001
  7. 7 generations backK081277 XPS 4000 System, Midas Rex Legend Ehs System, Integrated Power…Medtronic Xomed, Inc. · 2008 · Recalled
  8. 6 generations backK111520 Ipc Powerease SystemMedtronic Xomed, Inc. · 2011 · Recalled
  9. 5 generations backK121264 Triton Electric High Torque Handpiece and Software ModuleMedtronic Surgical Technologies · 2012
  10. 4 generations backK170312 IPC systems, Legend EHS handpieces and Legend Stylus Touch…Medtronic Powered Surgical Solutions · 2017
  11. 3 generations backK191597 Stealth Autoguide System, Midas Rex Legend Depth Stop SystemMedtronic Navigation, Inc. · 2019 · Recalled
  12. 2 generations backK210989 Cirq, Cirq Robotic Alignment System, Cirq Robotic Alignment Module…Brainlab AG · 2021
  13. 1 generation backK223864 Alignment System Cranial, Alignment Software Cranial, Cirq Alignment…Brainlab AG · 2023
  14. This deviceK243698 Alignment System Cranial, with Alignment Software Cranial with LITT…Brainlab AG · 2025

Class I recalls in this family

View FIG. 1 as a table

Line of descent and top descendants

GenerationNumberDeviceApplicantDecidedRecalls
−13K862807Treace Drill SystemTreace Medical, Inc.1986—
−12K964548Apex Universal Drive SystemLinvatec Corp.1997—
−11K971059Universal Drive SystemLinvatec Corp.1997—
−10K981637Integrated Drive/Pump System for OtolaryngologyLinvatec Corp.1998—
−9K990524E9000 SystemLinvatec Corp.1999—
−8K012456Sodem High Speed System (Electric) (Ear, Nose, and Throat)Sodemsystems2001—
−7K081277XPS 4000 System, Midas Rex Legend Ehs System, Integrated Power CONS0LE (Ipc)Medtronic Xomed, Inc.20081
−6K111520Ipc Powerease SystemMedtronic Xomed, Inc.20112
−5K121264Triton Electric High Torque Handpiece and Software ModuleMedtronic Surgical Technologies2012—
−4K170312IPC systems, Legend EHS handpieces and Legend Stylus Touch handpiece, Microsaw…Medtronic Powered Surgical Solutions2017—
−3K191597Stealth Autoguide System, Midas Rex Legend Depth Stop SystemMedtronic Navigation, Inc.20191
−2K210989Cirq, Cirq Robotic Alignment System, Cirq Robotic Alignment Module Cranial…Brainlab AG2021—
−1K223864Alignment System Cranial, Alignment Software Cranial, Cirq Alignment Software…Brainlab AG2023—
0 (this device)K243698Alignment System Cranial, with Alignment Software Cranial with LITT; Cirq…Brainlab AG2025—

Other ancestors by year cleared

Year clearedDevicesWith a Class I recall
198110
198410
198510
198610
198730
198820
198910
199010
199220
199440
199570
199610
199740
199840
199930
200080
200150
200260
200340
200460
200570
200650
200721
200820
200930
201021
201511
201710
202010
FIG. 1 — Lineage of K243698, 1986–2025Source: FDA 510(k) summaries, read by 510(k) Report · How lineage is built

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Notable FDA decisions, review times and new Class I recalls. See an issue.

Sources: FDA 510(k) database (decision fields), the FDA summary (predicates and indications), FDA recall and enforcement reports, and MAUDE; processed by 510(k) Report. Verify on FDA.gov · Methodology and accuracy.

3 devices in this family have a Class I recall. A 510(k) Report weighs predicate choices, recall history and review times for a new device like this one.

Top candidate predicates for a new HAW device

  1. #1 K253856 Geniant Cranial (Navigated Neurosurgical…score 15.0 · 11 generations · no Class I recall
  2. #2 Held for the reportin the report
  3. #3 Held for the reportin the report
Get a 510(k) Report

What was it cleared against? (2)

Devices the submitter claimed this one is substantially equivalent to (*), and reference devices cited for a specific test or feature (†), as written in the FDA summary.

TypeNumberDeviceApplicantDecidedRecalls
*K191597Stealth Autoguide System, Midas Rex Legend Depth Stop System
Summary page 5
…882.4560 Regulatory Class Class II Panel Neurology Predicate Device(s) Primary Predicate: K191597 Stealth Autoguide System Secondary Predicate: K223864 Alignment System Cranial…
Medtronic Navigation, Inc.20191
*K223864Alignment System Cranial, Alignment Software Cranial, Cirq Alignment Software Cranial…
Summary page 5
…Neurology Predicate Device(s) Primary Predicate: K191597 Stealth Autoguide System Secondary Predicate: K223864 Alignment System Cranial Contact Information Primary Contact…
Brainlab AG2023—

Also cleared against K191597: 3 other devices →

What descends from it?

No later submission names this one as a predicate yet.

Has anything in its family been recalled? (3 Class I)

No FDA recall names this device.

Relatives with a Class I recall

Class I is FDA’s most serious recall class. A recall in the family tree is context for this device, not evidence about it.

  • K151359ROSA BrainMedtech S.A · 2015 · 2 generations back · ◆ in the 2015 ancestors bar of FIG. 11 Class I recall
  • K092467Vectorvision Cranial, Vectorvision Ent, Kolibri Cranial, Kolibri Ent, Cranial Essential, Cranial UnlimitedBrainlab AG · 2010 · 3 generations back · ◆ in the 2010 ancestors bar of FIG. 11 Class I recall
  • K070106VV Fluoro 3DBrainlab AG · 2007 · 3 generations back · ◆ in the 2007 ancestors bar of FIG. 11 Class I recall

What does this lineage say?

  • The line of descent spans 39 years and passes through 8 companies; a new generation was cleared every 2.0 years on median.
  • 18 of the 102 ancestors have a recall of any class; 3 have a Class I recall.
  • 3 other devices also cite its predicate K191597.

How does its category compare?

All HAW devices

HAW Neurological Stereotaxic Instrument: FDA decisions, review times, recalls and adverse event reports over 20 years. 2025, this device’s year, is highlighted.

FDA decisions per year · HAW

9in 2025

2007: 152008: 122009: 82010: 62011: 42012: 82013: 32014: 52015: 102016: 92017: 72018: 62019: 102020: 52021: 92022: 72023: 142024: 72025: 92026 (partial year): 5
2007high 15 (2007) · low 3 (2013)2026

2026 to Oct 25, outlined.

Median 510(k) review, days · HAW

163in 2025

2007: 107 days median2008: 112 days median2009: 221 days median2010: 138 days median2011: 66 days median2012: 178 days median2013: 172 days median2014: 238 days median2015: 232 days median2016: 175 days median2017: 226 days median2018: 112 days median2019: 147 days median2020: 88 days median2021: 168 days median2022: 128 days median2023: 142 days median2024: 107 days median2025: 163 days median2026 (partial year): 162 days median
2007high 238 (2014) · low 66 (2011)2026

Receipt to decision; years with fewer than 3 clearances left blank.

Recalls per year · HAW

2in 2025

2007: 22008: 102009: 62010: 282011: 52012: 42013: 6, 1 Class I2014: 52015: 32016: 52017: 22018: 2, 2 Class I2019: 4, 1 Class I2020: 12021: 4, 2 Class I2022: 12023: 4, 1 Class I2024: 2, 2 Class I2025: 22026 (partial year): 6
2007high 28 (2010) · low 1 (2020)2026

Class I (9 since 2007) Class II/III not classified

Adverse event reports per year · HAW

3,425in 2025

2007: 492008: 532009: 962010: 2992011: 1,7252012: 9862013: 1,2902014: 1,6062015: 1,7672016: 1,8282017: 3,5052018: 4,4392019: 6,0622020: 3,4802021: 2,8272022: 1,9292023: 2,5102024: 3,7552025: 3,425
2007high 6,062 (2019) · low 49 (2007)2025

MAUDE reports naming product code HAW, not matched to any one device; reports are not rates.

View these four charts as a table
YearDecisionsMedian 510(k) review, daysRecalls (Class I)MAUDE reports
200715107249
2008121121053
20098221696
2010613828299
201146651,725
201281784986
201331726 (1)1,290
2014523851,606
20151023231,767
2016917551,828
2017722623,505
201861122 (2)4,439
2019101474 (1)6,062
202058813,480
202191684 (2)2,827
2022712811,929
2023141424 (1)2,510
202471072 (2)3,755
2025916323,425
202651626—

What is it indicated for?

Alignment System Cranial is intended to plan and to achieve a trajectory with surgical instruments during cranial stereotactic procedures.

The indications for use are biopsy of intracranial lesions, placement of stereoelectroencephalography (SEEG) electrodes and placement of anchor bolts for laser interstitial thermal therapy (LITT).

Indications for use as stated in the FDA summary.

Cite this page

510(k) Report. “K243698: Alignment System Cranial, with Alignment Software Cranial with LITT; Cirq Alignment Software Cranial Biopsy; Cirq Alignment Software Cranial sEEG; VarioGuide Alignment Software Cranial; Cirq Alignment Software Cranial LITT.” Lineage record from FDA 510(k) data and the FDA summary. Updated Nov 3, 2026. Accessed Nov 6, 2026. https://510kreport.com/device/K243698

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Record history
  • FDA decision record loaded May 2, 2026
  • Summary read Oct 13, 2026 (extraction version 9eaa42aa01ed)
  • Lineage and recalls computed Nov 3, 2026
  • Page last updated Nov 3, 2026