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It was reported that the procedure was to treat a lesion in the right coronary artery (rca).The 3.50x18mm xience skypoint stent delivery system (sds) met with resistance during advancement with the guide catheter.The sds was attempted to be removed from the gc; however, could not be removed; therefore, the sds and gc had to be removed as a single unit.Another gc and xience skypoint stent were used to continue the procedure.There was no adverse patient effect and no clinically significant delay reported in the procedure.No additional information was provided.
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A visual and dimensional inspection was performed on the returned device.The reported difficult to advance and difficult to remove could not be tested due to the condition of the returned device.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.A conclusive cause for the reported difficulties could not be determined; however, factors that could contribute to difficult to advance include, but are not limited to, patient anatomical morphology, patient disease state, guiding catheter support or damage to the guide catheter, anatomical conditions, inner diameter of guide wire lumen, outer diameter of the guide wire, interaction with previously placed stents or accessory devices.Factors that can contribute to difficult to remove include, but are not limited to, anatomical conditions, guiding catheter lumen obstructions, kinks, bends, procedural technique, insufficient support, or interactions with other devices.In this case, it is possible that inadvertent mishandling may have occurred during unpackaging, sheath/stylet removal or preparation of the device, causing the observed material deformation (lifted and bent stent struts).Further interaction with the guide catheter during advancement and retraction of the device, as resistance was noted, may have contributed to the reported difficult to advance and difficult to remove; 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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