It was reported that the 2.5x12 mm xience sierra stent was implanted in the left circumflex (lcx) coronary artery, but it jailed the obtuse marginal (om) side branch.The doctor intended to advance a guidewire through the already deployed stent strut in order to deploy another stent through the sierra for the om.The guidewire was advanced through the stent strut, but on fluoro, the guidewire had prolapsed.The guidewire was retracted when it was noted that the stent was no longer in the lcx.It was suspected that the guidewire had prolapsed around the stent, such that, when the guidewire was pulled back, the stent came with it.The stent was retracted into the guide catheter and was removed together as a unit with the guidewire and guide catheter.The procedure continued with a new guidewire to the om.A xience sierra stent was implanted in the om followed by another sierra in the lcx.There were no adverse patient effects and no clinically significant delay in the procedure.The patient was fine and was discharged home.No additional information was provided.
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The device was returned for analysis.The reported device damaged by another (explanted) was confirmed through observation.A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to this event.Additionally, a review of the complaint history identified no similar incidents from this lot.The reported patient effect of occlusion is listed in the xience sierra everolimus eluting coronary stent systems instructions for use as a known patient effect of coronary stenting procedures.The investigation determined the reported difficulties appear to be related to circumstances of the procedure.There is no indication of a product quality issue with respect to manufacture, design or labeling.
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