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D4 ¿ expiration date ¿ added d4 ¿ gtin ¿ updated h4 ¿ manufacturing date - added.There are controls in the manufacturing process to ensure the product met specifications upon release.The subject device was not available; therefore, a visual inspection as well as a functional evaluation could not be performed.The reported event is covered in the device directions for use (dfu).As well, the risk of the reported event is documented in the risk documentation and there are current controls to mitigate the risk of the as reported event.The reported events could not be confirmed, and it cannot be confirmed that the device met specification as the device was not returned.It was reported that when attempting to super selectively advance the guidewire in combination with the microcatheter to the upper trunk of the m2 segment, the guidewire became unresponsive to torque control.The physician withdrew the guidewire from the body and observed that the distal end of the guidewire exhibited signs of fracture and stretching.Additional information received indicates that the patient's anatomy was severely tortuous.The device was not returned for analysis, however based on the information received, it was stated that the patient's anatomy was severely tortuous.It is known that guidewire fractures may occur if manipulating through tortuous anatomy due to additional stresses that the anatomy can place on the guidewire during manipulation within the anatomy or within the devices being advanced.A guidewire becoming unresponsive to torque control is an indication of a fracture to the guidewire.It is probable that the guidewire was then stretched during the removal of the device.Based on the review of all available information, an assignable cause of procedural factors will be assigned to the reported ¿guidewire torque problem¿, ¿guidewire distal tip stretched¿ and ¿guidewire distal tip broken/fractured during use¿, as the issue is associated with a product that meets stryker design and manufacture specifications and was used in according with the dfu but due to procedural and/or anatomical factors during use, the product performance was limited.
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