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It was reported that the procedure was to treat a 90% lesion in left anterior descending (lad) artery.The 2.5x23mm xience skypoint stent delivery system (sds) advanced to the target lesion and the stent was implanted; however, stent implantation was slow due to the delivery system balloon ruptured at approximately 8 atmospheres (atm).Therefore, the stent did achieve adequate wall apposition and as a result, an additional balloon was used to completely implant the stent.There was no adverse patient effect and no clinically significant delay reported in the procedure.No additional information was provided.
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The device was returned for analysis.The reported material rupture was confirmed.The reported wall apposition could not be replicated in a testing environment as they are related to operational context of the procedure.The reported delayed/difficult activation could not be confirmed as the stent was not returned.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 reported information and the observations from the returned analysis, a definitive cause for the reported material rupture could not be determined.However, factors that may contribute to material ruptures include, but are not limited to, material damage, interactions with other devices or interaction with lesion calcification and tortuosity.The reported difficult activation of the stent, wall apposition and subsequent treatment appear to be related to operational context of the procedure as it is likely that because of the ruptured balloon the stent was unable to fully expand into the vessel wall.A post-dilation balloon was used to achieve proper apposition to the vessel wall, and the procedure was completed.There was no damage or leak noted to the stent delivery system (sds) during the inspection prior to use or during preparation of the device, which suggests a product quality issue did not contribute to the reported difficulties.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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