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It was reported that during treatment of critical limb ischemia with rest pain in the left lower extremity, an everflex entrust 7 x 150 x 120 stent was used to treat a calcified chronic total occlusion in the proximal left superficial femoral artery, with stent placement for dissection.The target vessel diameter was 6 mm, with severe lesion calcification and moderate tortuosity.A hostile aortic bifurcation was reported, with multiple episodes of sheath prolapse during the procedure.The vessel was pre-dilated with a 5 mm x 200 mm sterling balloon, and the instructions for use were followed without issue.After approximately 6 cm of stent deployment, the thumb wheel became difficult to rotate and subsequently locked.Troubleshooting by opening the delivery-system handle was attempted; however, tremendous resistance was encountered while retracting the silver inner sheath.The entire system was attempted to be removed which stretched the stent from the proximal sfa across the sfa and into the distal eia. a femoral cutdown was needed to remove the stent.The eia and cfa portions were removed but the proximal sfa segment was left behind.This segment was later refined with a covered stent(viabahn).Upon removal, the cook ansel 7 fr, 45 cm sheath had considerable sheath disruption with exposed braiding wires.It was speculated that the sheath condition played a part in the stent deployment difficulties.The device was not safely removed from the patient.The procedure was completed with surgical explantation and adjunctive endovascular repair.
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Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
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