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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 PROPATEN BIOACTIVE SURFACE; STENT, SUPERFICIAL FEMORAL ARTERY

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W. L. GORE & ASSOCIATES, INC. GORE® VIABAHN® ENDOPROSTHESIS WITH PROPATEN BIOACTIVE SURFACE; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Catalog Number PAJR050502E
Device Problems Adverse Event Without Identified Device or Use Problem (2993); Insufficient Information (3190)
Patient Problem Thrombosis/Thrombus (4440)
Event Date 07/16/2020
Event Type  Injury  
Manufacturer Narrative
As the device remains implanted, a further investigation on the device cannot be performed.The author was contacted to ask for further details like event date, serial no., implant date as well as possible root cause.Date of event was determined as date when literature article was published, here (b)(6) 2020.As patient age (b)(6) was determined and as gender male as mentioned in the article.Cbas¿ heparin surface incorporates cbas-heparin manufactured from heparin sodium api, which is covalently bound to the device surface and is essentially non-eluting.
 
Event Description
The following literature was reviewed: preliminary experience using a covered stent graft in patients with acute ischemic stroke and carotid tandem lesion" published by carlos pinana et al.In cardiovascular & interventional radiology 2020;43(11):1679-1686.The study reviews the use of a covered stent graft (gore¿ viabahn¿ endoprosthesis with propaten bioactive surface) for patients with acute ischemic stroke (ais) and tandem lesions in a high-volume comprehensive stroke center in a real-life scenario.A retrospective review of all patients that underwent carotid endovascular interventions during mechanical thrombectomy for ais using a self-expanding covered stent graft at vall dhebron university hospital between 2016 and 2018 was conducted.Patient clinical and angiographical characteristics as well as postoperative outcome and follow-up were recorded.A total of eight patients were treated with the covered stents.As post-procedural complications a high level of occlusion at three-month follow-up was found.The stents of five patients (patient 2, 3, 4, 5 and 6) were occluded, although the patients did not show signs of stroke recurrence.This case represents patient 4.
 
Manufacturer Narrative
The author came back and stated the following comment: initial good aspects and optimal reperfusion, but due to iv rtpa on board the antiplatelets were withheld until control ct.Aspirin was initiated, but the patient suffered a significant intracranial haemorrhage forcing its interruption, and leading to stent occlusion.A review of the manufacturing-, sterilization- and heparin coating records will be performed.
 
Manufacturer Narrative
H6: evaluation codes investigation findings 213 refers to the product history review: a review of the manufacturing records indicated the lot met all pre-release manufacturing specifications.The device remains implanted in the patient, therefore a device evaluation could not be performed.The information reported in the complaint, including reference patient clinical information did not add relevant information to further the device functionality investigation.Neither clinical images enabling direct assessment of product performance nor the product itself were returned for evaluation.With the information reported to gore this investigation is considered complete, the cause of the complaint was unable to be determined.
 
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Brand Name
GORE® VIABAHN® ENDOPROSTHESIS WITH PROPATEN 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
gunter marte
1505 n. fourth street
flagstaff, AZ 86004
9285263030
MDR Report Key12317343
MDR Text Key266377283
Report Number2017233-2021-02245
Device Sequence Number1
Product Code NIP
Combination Product (y/n)Y
Reporter Country CodeSP
PMA/PMN Number
P040037
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Literature,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 01/13/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/13/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date09/22/2019
Device Catalogue NumberPAJR050502E
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received12/15/2021
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 Number1
Patient Outcome(s) Required Intervention;
Patient Age52 YR
Patient SexMale
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