Medtronic received information regarding four pipeline devices that failed to open.The patient was undergoing a flow diversion procedure to treat an unruptured saccular aneurysm of the cavernous segment of an internal carotid artery (icu).The aneurysm max diameter was 14mm and the neck diameter was 8mm.The patient's vessel tortuosity was severe.Dual antiplatelet treatment (dapt) was administered with noted pru level of 160.It was reported that the second attempt to implant flow diverter was made with a 5 x 25mm pipeline (model: ped-500-25, lot: b067560).As had occurred with the first device, there was failure of the distal end to open and a noted "cigar" shape with more than 50% of the device deployed when it failed to open.The middle section of this pipeline was placed in a vessel bend.The pipeline was resheathed more than 2 times and redeployed but still did not open.No other additional steps or devices were tried to open this pipeline.It was resheathed and removed with the phenom microcatheter.There were no patient symptoms or complications reported related to the event.Post-procedure angiography revealed no issue.The aneurysm remained unruptured and there was no evidence of damage from the devices.
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