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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION EPIC VASCULAR; STENT, ILIAC

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BOSTON SCIENTIFIC CORPORATION EPIC VASCULAR; STENT, ILIAC Back to Search Results
Model Number 39202
Device Problems Difficult to Advance (2920); Positioning Problem (3009)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/21/2024
Event Type  malfunction  
Event Description
It was reported that stent migrated and did not fully cover the stenosis.The patient was presented with left femoral artery occlusion.The 90% stenosed target lesion was located in the severely tortuous and severely calcified superficial femoral artery.A 6x100x120 epic vascular was advanced for treatment.However, the stent was difficult to deliver to the target position.When deployed, it was noted that the stent migrated and did not fully cover the stenosis.There was no additional intervention performed.No complications were reported, and the patient was stable post procedure.
 
Event Description
It was reported that stent migrated and did not fully cover the stenosis.The patient was presented with left femoral artery occlusion.The 90% stenosed target lesion was located in the severely tortuous and severely calcified superficial femoral artery.A 6x100x120 epic vascular was advanced for treatment.However, the stent was difficult to deliver to the target position.When deployed, it was noted that the stent migrated and did not fully cover the stenosis.There was no additional intervention performed.No complications were reported, and the patient was stable post procedure.It was further reported that the stent could not arrived at the lesion and was not deployed.The stent was withdrawn directly.
 
Manufacturer Narrative
The device was received with the stent fully constrained in the correct position on the delivery system.A visual examination identified no issues with the tip of the device.A visual and tactile examination found no kinks or damage to the shaft of the device.A visual examination identified no issues or damage to the handle of the device.The safety lock was in place on the rack of the device.No other issues were identified during the product analysis.
 
Event Description
It was reported that stent migrated and did not fully cover the stenosis.The patient was presented with left femoral artery occlusion.The 90% stenosed target lesion was located in the severely tortuous and severely calcified superficial femoral artery.A 6x100x120 epic vascular was advanced for treatment.However, the stent was difficult to deliver to the target position.When deployed, it was noted that the stent migrated and did not fully cover the stenosis.There was no additional intervention performed.No complications were reported, and the patient was stable post procedure.It was further reported that the stent could not arrived at the lesion and was not deployed.The stent was withdrawn directly.
 
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Brand Name
EPIC VASCULAR
Type of Device
STENT, ILIAC
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
ballybrit business park
galway
EI  
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key19190875
MDR Text Key341132788
Report Number2124215-2024-21977
Device Sequence Number1
Product Code NIO
UDI-Device Identifier08714729805205
UDI-Public08714729805205
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
P110035
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional,Company Representative,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 05/22/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number39202
Device Catalogue Number39202
Device Lot Number0027721933
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/31/2024
Initial Date FDA Received04/26/2024
Supplement Dates Manufacturer Received05/05/2024
Supplement Dates FDA Received05/22/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured07/23/2021
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 Age64 YR
Patient SexMale
Patient Weight78 KG
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