Device Problem
Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problem
Vascular Dissection (3160)
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Event Date 03/18/2024 |
Event Type
Injury
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Event Description
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It was reported that the procedure was performed to treat a lesion in the proximal left anterior descending (lad) coronary artery with moderate calcification, moderate tortuosity and 80% stenosis.Pre-dilation was performed with a 1.5x12mm and a 2.0x12mm mini trek balloon dilating catheter to 8 atmospheres.The 3.5x38mm xience alpine stent was deployed at 10 atmospheres and the stent delivery system was removed.An angiogram revealed a dissection at the distal edge of the stent.A 3.5x23mm xience alpine stent was used to treat the dissection with resulted in adequate hemodynamic flow without residual stenosis.There were no adverse patient sequela.No additional information was provided.
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Manufacturer Narrative
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The device was not returned for analysis.Lot history record (lhr) and exception reviews were performed and revealed no indication of a product quality issue.Additionally, a review of the complaint history identified no similar incidents from this lot.A conclusive cause for the reported patient effect(s), and the relationship to the product, if any, cannot be determined; however, the subsequent treatment appears to be related to the operational context of the procedure.There is no indication of a product quality issue with respect to manufacture, design or labeling; therefore, no product-related corrective action will be implemented in this case.The reported patient effect of dissection is listed in the xience alpine everolimus eluting coronary stent system (eifu), electronic instructions for use as a known patient effect of coronary stenting procedures.
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Manufacturer Narrative
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The device was not returned for analysis.An exception review was performed and revealed no indication of a product quality issue.A review of the electronic lot history record (elhr) and lot level similar incident for this product was not performed because the part and lot numbers were not reported and the product was not returned for analysis.The reported patient effect of dissection is listed in the xience v everolimus eluting coronary stent system as a known patient effect of coronary stenting procedures.A conclusive cause for the reported patient effects, and the relationship to the product, if any, cannot be determined; however, the subsequent treatment appears to be related to the operational context of the procedure.There is no indication of a product quality issue with respect to manufacture, design or labeling; therefore, no product-related corrective action will be implemented in this case.D4: the udi number is not known as the part and lot number were not provided.H6 - type of investigation; 4109 historical data analysis was removed.
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Search Alerts/Recalls
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