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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: W. L. GORE & ASSOCIATES, INC. GORE VIABAHN ENDOPROSTHESIS WITH HEPARIN BIOACTIVE SURFACE; STENT, SUPERFICIAL FEMORAL ARTERY

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W. L. GORE & ASSOCIATES, INC. GORE VIABAHN ENDOPROSTHESIS WITH HEPARIN BIOACTIVE SURFACE; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Device Problem Migration or Expulsion of Device (1395)
Patient Problem Perforation (2001)
Event Date 07/17/2019
Event Type  Injury  
Manufacturer Narrative
The item number and lot number of the device could not be provided, so no manufacturing evaluation could not be performed.The device remains implanted.Therefore, direct product analysis was not possible.
 
Event Description
The following publication was reviewed: "retrograde branched endovascular repair as a feasible option to treat complex aortic aneurysm using the retrograde branched extension limb assembling technique" received through "j vasc interv radiol 2019; 30:1956¿1963".The authors: yuan he, md, wei guo, md, jiang xiong, md, jie liu, md, et al.The article aimed to present the primary experiences in treating suprarenal aneurysms, juxtarenal aneurysms, thoracoabdominal aortic aneurysms, and aneurysms after dissection with hostile anatomical features using the retrograde branched extension limb assembling (rebel) technique.The study included 23 consecutive patients undergoing total endovascular repair with the rebel technique from august 2014 to january 2019.Twelve patients had abdominal aortic aneurysms (4 juxtarenal, 8 suprarenal), 6 had thoracoabdominal aortic aneurysms (type iv), and 5 had postdissection aneurysms.During the procedures, polytetrafluoroethylene-covered vascular prostheses or viabahn stents were chosen as the suspended bridge endografts.Reported results stated in the first patient, migration of the distal part of the suspended bridge in the right renal stent was reported at 6 months postoperatively; this patient was then successfully treated with additional bare metal balloon stenting.
 
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Brand Name
GORE VIABAHN ENDOPROSTHESIS WITH HEPARIN BIOACTIVE SURFACE
Type of Device
STENT, SUPERFICIAL FEMORAL ARTERY
Manufacturer (Section D)
W. L. GORE & ASSOCIATES, INC.
1505 n. fourth street
flagstaff AZ 86004
Manufacturer (Section G)
MEDICAL ECHO RIDGE B/P
3250 w. kiltie lane
flagstaff AZ 86005
Manufacturer Contact
pixie xi
1505 n. fourth street
flagstaff, AZ 86004
9285263030
MDR Report Key10492823
MDR Text Key205936342
Report Number2017233-2020-01221
Device Sequence Number1
Product Code NIP
Combination Product (y/n)Y
Reporter Country CodeCH
PMA/PMN Number
P040037
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type literature
Reporter Occupation Physician
Type of Report Initial
Report Date 09/04/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/04/2020
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received08/12/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age69
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