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It was reported that the procedure was performed to treat a heavily calcified and mildly tortuous lesion in the left anterior descending (lad).A 2.25x23mm xience skypoint drug-eluting stent (des) was attempted to be advanced into the lesion; however, failed to cross.Upon removing the des from the anatomy, it was observed that the stent had become dislodged and loose from the balloon.Therefore, the des was replaced with a non-abbott device and the procedure was completed.There were no adverse patient effects nor clinical delay reported.No additional information was provided.
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A visual inspection was performed on the returned device.The reported stent dislodgement was confirmed.The reported failure to advance could not be evaluated as the exact anatomical conditions encountered by the device used during the procedure could not be replicated in the test laboratory.Production record and corrective and preventative actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a query of the complaint handling database for the reported lot revealed there is no indication of a lot specific issue.Based on the information provided and analysis of the returned device, a definitive cause for the reported difficulties could not be determined.Stent dislodgement may be attributed to several factors including, but not limited to, positive pressure during preparation, forced sheath removal, handling of the stent during preparation, and interaction with patent anatomy or accessory devices.Factors that could contribute to failure to advance include, but are not limited to, patient anatomical morphology, patient disease state, pre-dilatation strategy, device placement technique, interaction with previously placed stents or accessory devices.In this case, it is possible that the device may have interacted with the heavily calcified, mildly tortuous lesion during advancement, causing the reported failure to advance.Further interaction with the challenging anatomy during retraction of the device, as resistance was noted, may have contributed to the reported stent dislodgement; however, this cannot be confirmed.Based on the 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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