An angiodynamics executive district sales manager reported an issue with a 2.0mm eximo atherectomy catheter.The device was used in a 6f cook sheath and sheared off a long and large section of the sheath.This was noted after the device was removed between treatments.The procedure was completed with a 1.5mm device and the patient did not experience any adverse effects, harm, or require medical intervention as a result of this incident.It was indicated the reported device is available for return to the manufacturer for a device evaluation.
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As the reported device was not returned, angiodynamics is unable to perform a device evaluation.The customer's reported complaint of sheath detached due to catheter being unable to advance/cross the bifurcation cannot be confirmed since the complaint device was not returned for evaluation.Without receiving a catheter sample for evaluation, a definitive root cause for this event could not be determined.The lot/serial number of the catheter used was not reported by the end user, therefore, a dhr review could not be performed.Labeling review: instructions for use is provided with the catheter device and contain the following statements: warnings: pay careful attention while using the catheter, avoid excessive force and be on alert for any potential damage.Inadvertent movement of the catheter may result in patient injury.Always use fluoroscopic surveillance when advancing the auryon catheter inside the patient vasculature to avoid misplacement, dissection, or perforation.Auryon catheter insertion over the wire until laser activation: you may use any other gw to cross the lesion, but the final gw that auryon catheters will track over should be 300cm 0.014", and preferably stiff gws.Once this gw is angiographically verified to cross the lesion in the vessel's lumen, it is ready for auryon catheter insertion over the wire.Advancement of auryon catheter through the lesion: do not to exceed 10 seconds of lasing at the same location.If you experience any difficulty to advance the auryon catheter, immediately start self-count-down.Self-count-down should start the moment you experience non-advancement of the auryon catheter.When advancement resumes, you should stop self-count-down and resume it if additional non-advancements are experienced.If the auryon catheter cannot be advanced by the 10th second of laser activation, you should release the foot switch to stop the laser, retract the catheter approximately 3-4 mm, and try to advance again while rotating the catheter shaft approximately 90 degrees to either side, while resuming 10 seconds count down.If the auryon catheter is still not advancing with the above-mentioned rotation manipulation for the additional 10-seconds, immediately stop the laser activity by releasing the footswitch.Ask the laser operator to raise the fluence to the 60mj/mm2.Activate the laser and try again to advance the auryon catheter through the lesion.If the auryon catheter cannot be advanced, resume the self-count-down to 10 seconds.If the auryon catheter cannot be advanced in this attempt, stop the laser activity, withdraw the auryon catheter and use a new catheter.A review of the angiodynamics complaint system noted no adverse trends for this complaint type and product family.This type of complaint will continue to be monitored for trends.Reference (b)(4).
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