MAUDE Adverse Event Report: COOK IRELAND LTD ZILVER PTX 35 DRUG-ELUTING STENT; NIU STENT, SUPERFICIAL FEMORAL ARTERY, DRUG-ELUTING

Catalog Number UNKNOWN

Device Problems Fracture (1260); Structural Problem (2506)

Patient Problems No Information (3190); No Clinical Signs, Symptoms or Conditions (4582)

Event Date 07/01/2019

Event Type  Injury  

Manufacturer Narrative

Investigation is still pending, a follow up mdr will be submitted to include the investigation conclusions.

Event Description

Ichihashi et al 2019 (zilver ptx) ¿ ¿vessel calcification as a risk factor for in-stent restenosis in complex femoropopliteal lesions after zilver ptx paclitaxel-coated stent placement.¿ the selection of guidewires, subintimal/intraluminal passage, and sizes of balloons and stents were at the opera-tor¿s discretion.After 6-f sheath insertion, unfractionated heparin (5000 units) was administered.Intravascular ultrasound (ivus) was used at the operator¿s discretion to assess vessel diameter for balloon and stent selection.Stenting with zilver ptx was performed successfully in every limb without significant residual stenosis.Stented length was 16.2±9.3 cm (range 4¿40).Forty lesions were recanalized via a total or partial subintimal passage.There were 3 (1.3%) cases of stent fracture reported during follow-up.

Manufacturer Narrative

Device evaluation: the zisv6 devices of unknown lot number involved in this complaint were not available for evaluation.With the information provided, a document-based investigation was conducted.As the rpn and lot number of the complaint stents are unknown, a review of the relevant manufacturing records cannot be conducted.However, prior to distribution all [insert rpn or prefix here] devices are subject to visual a visual inspection and functional checks to ensure device integrity.These inspections and functional checks are outlined in internal procedures in place at cirl.It should be noted that stent strut fracture is listed as a known potential adverse event within the instructions for use (ifu0117-5).The stent is proven to withstand the equivalent of 10 years of walking post implantation therefore 3 fractured stents in a study of 230 treated limbs after 5 years could be specific to the patients themselves.A study titled stent fractures after superficial femoral artery stenting: risk factors and impact on patency from 2015 suggests that fracture is more likely in patients with chronic total occlusion (cto) after treatment for longer stented lesions.The ichihashi literature studied long lesions (mean length of 164cm) and documents 104 patients with chronic total occlusion there is no evidence to suggest the user did not follow the ifu.A definitive root cause could not be determined from the available information.A possible root cause could be attributed to patient pre-existing/underlying conditions.From the literature article it is known that patient pre-existing conditions included hypertension, hyperlipidaemia, diabetes, smoking, coronary artery disease (cad), renal insufficiency, critical limb ischemia and rutherford classifications between 2 and 5.The complaint is confirmed based on customer testimony.The patient¿s outcome is unknown.Complaints of this nature will continue to be monitored for potential emerging trends.

Event Description

Supplemental report is being submitted due to the completion of the investigation.

• Brand Name: ZILVER PTX 35 DRUG-ELUTING STENT
• Type of Device: NIU STENT, SUPERFICIAL FEMORAL ARTERY, DRUG-ELUTING
• Manufacturer (Section D): COOK IRELAND LTD; o halloran road; limerick
• Manufacturer (Section G): COOK IRELAND LTD; o halloran road; national technology park; limerick
• Manufacturer Contact: aisling hassett ; o halloran road; national technology park; limerick
• MDR Report Key: 10834699
• MDR Text Key: 216322312
• Report Number: 3001845648-2020-00856
• Device Sequence Number: 1
• Product Code: NIU
• Combination Product (y/n): Y
• PMA/PMN Number: P100022
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Literature
• Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date: 12/09/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 11/13/2020
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: UNKNOWN
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Distributor Facility Aware Date: 07/01/2019
• Event Location: Hospital
• Date Manufacturer Received: 10/13/2020
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 73 YR
• Patient Sex: Male