STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY TREVO PROVUE 4MM X 20MM; CATHETER, THROMBUS RETRIEVER
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Model Number 90184 |
Device Problem
Fracture (1260)
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Patient Problem
No Clinical Signs, Symptoms or Conditions (4582)
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Event Date 02/21/2023 |
Event Type
malfunction
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Event Description
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It was reported that during the right ica c6 acute occlusion procedure, physician delivered intermediate catheter to c4 and reached c6 under aspiration.Physician used the adapt technique to aspirate the thrombus, but the ica was still occluded.Using guidewire, the microcatheter was brought to right mca m2 and then deployed the subject stent retriever.The physician used the solumbra technique and retracted the subject stent retriever at the same time.However, resistance was felt when the subject stent retriever went into the tip of the intermediate catheter.The physician pulled the subject stent out from tail of intermediate catheter and found that the connection between stent and delivery wire was fractured.Took the stent out and confirmed that much thrombus was taken out.Then continued to use intermediate catheter to aspirate but middle of m1 to distal was still occluded.Then used a guidewire and microcatheter to bring intermediate catheter to m1 to aspirate with adapt technique.Finally, the vessel was clear and confirmed tici 3.The procedure was completed successfully.No clinical consequences were reported to the patient due to this event.
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Manufacturer Narrative
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The device is not available to the manufacturer.
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Event Description
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It was reported that during the right ica c6 acute occlusion procedure, physician delivered intermediate catheter to c4 and reached c6 under aspiration.Physician used the adapt technique to aspirate the thrombus, but the ica was still occluded.Using guidewire, the microcatheter was brought to right mca m2 and then deployed the subject stent retriever.The physician used the solumbra technique and retracted the subject stent retriever at the same time.However, resistance was felt when the subject stent retriever went into the tip of the intermediate catheter.The physician pulled the subject stent out from tail of intermediate catheter and found that the connection between stent and delivery wire was fractured.Took the stent out and confirmed that much thrombus was taken out.Then continued to use intermediate catheter to aspirate but middle of m1 to distal was still occluded.Then used a guidewire and microcatheter to bring intermediate catheter to m1 to aspirate with adapt technique.Finally, the vessel was clear and confirmed tici 3.The procedure was completed successfully.No clinical consequences were reported to the patient due to this event.
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Manufacturer Narrative
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There are controls in the manufacturing process to ensure the product met specifications upon release.The subject device is not available; therefore, functional testing as well as visual testing cannot be performed.The reported event is covered in the device directions for use (dfu).As well, the risk of the reported event is documented in the risk documentation and there are current controls to mitigate the risk of the as reported event.The reported event could not be confirmed, and it cannot be confirmed that the device met specification, as the device was not returned.It was reported that when the stent went into tip of intermediate catheter it felt resistance.The operator pulled the stent out from tail of intermediate catheter and found the connection between stent and delivery wire was fractured.Took the stent out and confirmed that much thrombus was taken out.Additional information states that the patient¿s anatomy was moderately tortuous.The retriever was pulled out from the body with the stent of the support wire.It is probable that the retriever experience in pulling the retriever/ clot back to the distal end of the intermediate catheter, causing the distal end of the retriever to separate from its core wire, however as the device was not returned for analysis, this cannot be definitively determined, therefore an assignable cause of undeterminable will be assigned to as reported "retriever fractured/broken during use' and 'retriever difficult/unable to go through catheter shaft.
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