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It was reported that the procedure was to treat a 90% de novo lesion in the right coronary artery (rca) with heavy calcification and moderate tortuosity.After pre-dilation, the 3 x 18 mm xience skypoint stent delivery system (sds) was advanced to the target lesion with resistance due to the anatomy.However, during the initial inflation the delivery system balloon ruptured at 6 atmospheres (atm).The stent remained mounted on the delivery system and therefore, was able to be removed with the delivery system.The procedure was continued with additional dilatation followed by implantation of a 2.75 x 18 mm xience skypoint stent and post-dilatation.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 not returned for analysis.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, a definitive cause for the reported issue could not be determined; however, factors that may contribute to material ruptures include, but are not limited to, material damage, inflation technique, interactions with other devices, lesion calcification and tortuosity or insufficient preparation prior to use.Difficult to advance/position may be attributed to several factors including, but are not limited to, product placement technique, guiding catheter support, anatomical conditions, condition of the guide wire, interaction with accessory devices, damage to the catheter, patient disease state, or interaction with previously placed stents.In this case, it is possible the device may have interacted with the heavily calcified, moderately tortuous, 90% stenosed lesion during advancement, as resistance was noted, causing the reported difficult to advance.Further interaction with the challenging anatomy during positioning of the stent may have contributed to the reported material rupture; however, based on the information provided and without the device to examine, 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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