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It was reported that the procedure was to treat a moderately calcified and 90% stenosed, de novo, lesion in the superficial femoral artery using three absolute pro self-expanding stent systems (sess).An unspecified 0.035 guide wire was advanced, and the first 6.0x80 absolute pro sess was advanced; however, unspecified resistance was noted, making tracking difficult.Deployment was initiated and noted as difficult due to stiffness in turning the thumbwheel.After stent deployment, the physician noted the stent was not fully expanded, necessitating the use of a 6.0x200mm dilatation catheter balloon to fully expand the stent.After balloon expansion, the stent jumped forward between 2mm and 5mm, remaining partially in the target lesion and also in health tissue.The second 6.0x80mm absolute pro was advanced and experienced the same occurrence.Next, the third 6.0x60mm absolute pro was deployed and experienced the same occurrence; however, this stent remained in place after balloon expansion.A fourth 6.0x100mm absolute pro was implanted to treat the target areas left uncovered by the previous stents moving forward.This stent also encountered unspecified resistance during advancement making tracking difficult.Deployment was noted as difficult due to stiffness in turning the thumbwheel.After stent deployment, the physician noted the stent did not fully expand, necessitating the use of the same 6.0x200mm balloon dilatation catheter.There were no adverse patient sequela and no reported clinically significant delay in the procedure.No additional information was provided.
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The device was not returned for analysis.Production record and corrective and preventive actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a review of the complaint handling database identified no other incidents from this lot.It is possible that interaction with the moderately calcified and 90% stenosed anatomy resulted in the reported difficult to advance and during stent deployment resulted in preventing the shaft lumens from moving freely resulting in the reported physical resistance / sticking thumbwheel and thus resulting in the reported difficult or delayed activation; however this cannot be confirmed.The investigation determined a conclusive cause for the reported difficult to advance, physical resistance / sticking and difficult or delayed activation cannot be determined.The treatment(s) appears to be related to the operational context of the procedure as a fourth 6.0x100mm absolute pro was implanted to treat the target areas left uncovered by the previous stents moving forward.Based on the reported information and results of the complaint investigation there is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
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