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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 difficulties could not be determined; however, 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 could contribute to material deformation include, but are not limited to, inadvertent mishandling during sheath/stylet removal, preparation, during use of the device, interaction with anatomy or accessory devices.Factors that can contribute to difficult to remove include, but are not limited to, kinks, bends, procedural technique, insufficient support, patient disease state, or interactions with other devices.In this case, it is possible the device may have interacted with the heavily calcified, mildly tortuous lesion during advancement, causing the reported failure to advance.Further interaction with the challenging anatomy during retraction of the device may have contributed to the reported material deformation, as resistance was noted, ultimately causing the reported difficult to remove; however, based on the information provided, this cannot be confirmed.It was reported the device failed to cross the lesion.The device was removed, a guide liner was inserted, and the stent was re-inserted.It should be noted that the xience skypoint, electronic instructions for use (eifu) states: an unexpanded stent may be retracted into the guiding catheter one time only.An unexpanded stent should not be reintroduced into the artery once it has been pulled back into the guiding catheter.Subsequent movement in and out through the distal end of the guiding catheter should not be performed, as the stent may be damaged or dislodge during retraction back into the guiding catheter.It is unknown if the ifu deviation directly caused or contributed to the reported event.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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It was reported that the procedure was to treat a de novo, heavily calcified, mildly tortuous right coronary artery lesion.A 3.5x48 mm xience skypoint drug-eluding stent delivery system (sds) was advanced to the target lesion.However, it failed to cross the lesion.A guideliner was inserted and the des was advanced again.However, it again failed to cross the lesion.During removal, resistance was noted between the sds and guidliner, causing the edges of the stent to be mangled.Both devices were removed together.A new 3.5x48 mm xience skypoint sds and guideliner were used to complete the procedure.There were no adverse patient effects and there was no clinically significant delay in the procedure.No additional information was provided.
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