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It was reported that the patient presented with an acute ischemic stroke involving a tandem occlusion, with the target clot located in the middle cerebral artery (mca).Access was obtained through the right femoral artery using a zoom support catheter which was introduced through a third-party sheath.During the procedure, resistance was encountered during advancement/retraction through the carotid artery.Imaging indicated that the access catheter as well as zoom 35 kinked due to extreme tortuous anatomy.The physician exchanged the zoom support access catheter for a third-party guide catheter.Upon removal, the zoom 35 catheter was found to have fractured, with separation occurring approximately 30 cm from the distal end.An attempt to retrieve the separated catheter segment using a snare was unsuccessful, and the distal catheter segment remained within the patient's vasculature.The procedure was subsequently concluded, as the earlier thrombectomy attempt using the zoom 35 catheter had been unsuccessful.It was further reported that the patient expired a couple of days following the procedure; however, the exact date of death was not known.Based on the information provided, the cause of death could not be conclusively determined.According to the treating physician, the patient was considered high risk, and the physician believed the patient's death was unrelated to the reported device event.
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The zoom 35 was discarded and not returned for investigation.The manufacturing records confirmed the product met all the design and manufacturing specifications.Without the return of the device, the exact root cause for the shaft break could not be determined.However, based on the available information, likely factors which contributed to the reported complaint were tortuous anatomy and advancement/retraction of the zoom 35 against resistance.Zoom ifu provides the following warning related to retraction against resistance."exercise care when manipulating the device through tortuous anatomy.Do not advance or withdraw the catheters or accessory/adjunctive devices against resistance without careful assessment of the cause under fluoroscopy.If the cause cannot be determined, withdraw all devices as a single unit.Excessive manipulation or torquing the device against resistance may result in damage to the vasculature or the device.".
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