A review of the images provided show the graft in place with a small amount of threads of eptfe still attached to the implanted graft.The instructions for use (ifu) states the following in regards to removal of the external rings or helix from the graft."instructions on removal of external ¿rings¿ or ¿helix¿ from the advanta vxt vascular graft.While the rings are added to the advanta vxt to improve kink, compression and torque resistance, a physician may choose to remove portions of it for surgical/technical reasons.The steps to do so are as follows: 1.Hold the graft flat (horizontal).2.Take the very distal portion of the ptfe ring with a pair of forceps and slowly pull off the ring at a 45 degree angle, being mindful not to catch the outer soft wrap.3.If the external support rings are pulled too quickly, it is possible for a small portion of the vxt outer wrap to be removed.Should the outer wrap fray, the physician is still left with the base layer, which will be sufficient to complete the procedure.A corrective and preventative action (capa) has been generated to evaluate the issue along with a health hazard evaluation (hhe) for the clinical evaluation which states the following: rationale for probability and health risk: incorrect removal of the helix wrap is very likely to cause the observed shredding phenomena.The probability of this occurring is greater when longer portions of the helix are removed.The design of the graft (base + two overlapping helix wrap layers) makes the risk of an adverse event such as graft disruption (which could result in bleeding and or pseudoaneurysm formation) highly improbable.Medical summary: shredding of the advanta vht has been observed with the removal of the outer supporting helix wrap.Removal of some portion of the helix is commonly performed as part of the implantation procedure.Clarifications of the correct method of helix removal within the ifu may mitigate this problem from occurring which can result in user inconvenience and increase operative time.Based on the review of the device history records and product complaint details atrium can find no fault with the device in question.It is possible that the wrap was not removed as instructed within the instructions for use.H3 other text : product not available.
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