It was reported that on (b)(6) 2012, the patient underwent a stenting procedure with placement of a 4.0 x 23 mm xience prime stent and a 3.0 x 28 mm xience prime stent in the left main coronary artery to circumflex artery.No post procedure intravascular ultrasound (ivus) was performed as the physician had difficulty advancing the ivus through the 3.0 x 28 mm xience prime.On (b)(6) 2012, the patient began experiencing non-serious increased fatigue.Patient was advised to take his betablocker at night rather than in the morning.On (b)(6) 2013, the patient experienced an episode of angina.The patient's medication dosages were changed.No additional intervention was provided and the chest pain continued.As the patient's angina continued, angiography was performed on (b)(6) 2014.Angiography noted instent restenosis in the stents implanted in the left main to the ostial circumflex.Additionally, the 3.0 x 28 mm xience prime was noted to be undersized, possibly related to the index procedure t-stenting technique.A 4.0 x 33 mm xience stent and a 3.0 x 12 mm xience stent were implanted in the cx artery back to the left main artery.Dilatation was performed in the left anterior descending (lad) artery, using an unspecified 3.0 mm balloon, followed by kissing balloon technique using an unspecified 3.0 balloon in the lad and a 4.0 balloon in the cx.There was poor flow distally (ischemia) and plain old balloon angioplasty (poba) was performed using an unspecified 2.5 nc balloon and then drug eluting balloon to the 2nd obtuse marginal with excellent final results.No additional information was provided.
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(b)(4).The device was not returned for evaluation; therefore a failure analysis of the complaint device could not be completed.A review of the lot history record revealed no non-conformances that would have contributed to the reported event.A query of the electronic complaint handling database indicated there had been no similar incidents reported for this lot.The reported patient effects of angina, ischemia, and restenosis are known observed and potential patient effects as listed in the xience prime everolimus eluting coronary stent system instructions for use.Based on the reviewed information, no product deficiency was identified.The 4.0x23mm xience prime referenced is being filed under a separate medwatch mfr number.
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