MAUDE Adverse Event Report: MEDTRONIC IRELAND IN.PACT ADMIRAL PACLITAXEL-ELUTING PTA BALLOON CATHETER; DRUG-ELUTING PERIPHERAL TRANSLUMINAL ANGIOPLASTY CATHETER

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problems Occlusion (1984); Reocclusion (1985); Patient Problem/Medical Problem (2688)

Event Date 01/26/2019

Event Type  Injury  

Manufacturer Narrative

Age or date of birth: average age.Sex: majority gender.Outcomes to adverse event, event date: article publish date."drug-eluting balloon angioplasty versus uncoated balloon angioplasty for the treatment of in-stent restenosis of the femoropopliteal arteries." cochrane database of systematic reviews 2019, issue 1.Art.No.: cd012510.Doi: 10.1002/14651858.Cd012510.Pub2.If information is provided in the future, a supplemental report will be issued.

Event Description

Background: stents are placed in the femoropopliteal arteries for numerous reasons, such as atherosclerotic disease, the need for dissection, and perforation of the arteries, and can become stenosed with the passage of time.When a stent develops a flow-limiting stenosis, this process is known as ¿in-stent stenosis.¿ it is thought that in-stent restenosis is caused by a process known as ¿intimal hyperplasia¿ rather than by the progression of atherosclerotic disease.Management of in-stent restenosis may include performing balloon angioplasty, deploying another stent within the stenosed stent to force it open, and creating a bypass to deliver blood around the stent.The role of drug-eluting technologies, such as drug-eluting balloons (debs), in the management of in-stent restenosis is unclear.Drug-eluting balloons might function by coating the inside of stenosed stents with cytotoxic chemicals such as paclitaxel and by inhibiting the hyperplastic processes responsible for in-stent restenosis.It is important to perform this systematic review to evaluate the efficacy of deb because of the potential for increased expenses associated with debs over uncoated balloon angioplasty, also known as plain old balloon angioplasty (poba).Event description: 263 patients participated in clinical trials for deb.Inpact admiral and admiral xtreme were used in fair trial.Pacific xtreme and inpact admiral were used in the isar-pebis trial.No medtronic device was used in pacuba trial.The devices were used to treat the superficial femoral artery and femoral popliteal arteries.The patients have a history of pad, in-stent restenosis, re-occlusion, diabetes.Ischemia and foot infection.The vessels were pre-dilated with inflation time of 2 mins.None of the studies reported amputation free survival and no major or minor lower extremity amputations were reported at the one, six, twelve or twenty-four month follow ups.None of the studies reported late lumen loss.Postoperatively: participants received aspirin 100 mg/d indefinitely and clopidogrel 75 mg/d for at least 6 months the patients presented post procedure with two target lesion revascularisations (tlr) from the isar pebis trial only at the six and the twelve month follow up.There was no tlr reported in the fair trial.The fair and isar pebis trial reported one case of restenosis each at six months follow up.The fair trial reported one case of restenosis at the twelve month follow up.The fair and isar pebis trial reported one death each at the six month follow up.The fair trial reported a death at the twelve month follow up.The isar pebis trial reported one death at the twenty-four month follow up.Bail out stenting, medication, hospitalization and , re-occlusion were also reported as outcomes from this study.Objectives: to assess the safety and efficacy of debs compared with uncoated balloon angioplasty in people with in-stent restenosis of the femoropopliteal arteries as assessed by criteria such as amputation-free survival, vessel patency, target lesion revascularization, binary restenosis rate, and death.We define ¿in-stent restenosis¿ as 50%or greater narrowing of a previously stented vessel by duplex ultrasound.

Manufacturer Narrative

Correction to event date (article publish date).If information is provided in the future, a supplemental report will be issued.

• Brand Name: IN.PACT ADMIRAL PACLITAXEL-ELUTING PTA BALLOON CATHETER
• Type of Device: DRUG-ELUTING PERIPHERAL TRANSLUMINAL ANGIOPLASTY CATHETER
• Manufacturer (Section D): MEDTRONIC IRELAND; parkmore business park west; galway
• Manufacturer (Section G): MEDTRONIC IRELAND; parkmore business park west; galway
• Manufacturer Contact: toni o'doherty ; parkmore business park west; galway ; 091708734
• MDR Report Key: 8423756
• MDR Text Key: 138902406
• Report Number: 9612164-2019-00891
• Device Sequence Number: 1
• Product Code: ONU
• Combination Product (y/n): N
• Reporter Country Code: CA
• PMA/PMN Number: P140010
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,literature
• Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date: 03/15/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 03/15/2019
• Initial Date FDA Received: 03/15/2019
• Supplement Dates Manufacturer Received: 03/15/2019
• Supplement Dates FDA Received: 03/15/2019
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 68 YR