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A visual and dimensional inspection was performed on the returned device.The reported failure to advance and difficult to remove 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.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.Factors that can contribute to difficult to remove include, but are not limited to, kinks, bends, positive pressure during preparation, patient anatomical morphology, patient disease state, procedural technique, insufficient support, or interactions with other devices.There was no damage noted to the stent delivery system (sds) during the inspection prior to use which suggests a product quality issue did not contribute to the reported difficulties.In this case, it is possible that the device may have interacted with the heavily calcified lesion during advancement, as resistance was noted, contributing to the reported failure to advance in addition to the observed material deformation (stretched and bent distal stent struts).Further interaction with the challenging anatomy during retraction of the device, as resistance was again noted, may have contributed to the observed stretched, bent, flared, smashed, and crushed proximal stent damage, ultimately causing the reported 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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