FDA Adverse Event Injury Summary report: N

FEP RINGED GORE-TEX STRETCH VASCULAR GRAFT

MDR report key: 1332937 · Received February 27, 2009

Report

Report Number
2017233-2009-00114
Event Type
Injury
Date Received
February 27, 2009
Report Date
February 27, 2009
Manufacturer
W.L. GORE & ASSOCIATES
Product Code
DSY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ARTICLE IS ATTACHED. INOUE Y, SUGANO N, JIBIKI M, ET AL. CUFFED ANASTOMOSIS FOR ABOVE-KNEE FEMOROPOPLITEAL BYPASS WITH A STRETCH EXPANDED POLYTETRAFLUOROETHYLENE GRAFT. SURGERY TODAY 2008; 38:679-684.

Description of Event or Problem · 1

IN THE MEDICAL LITERATURE, IT WAS REPORTED THAT BETWEEN 1997 AND 2005, A PATIENT WAS IMPLANTED WITH A 6MM THIN-WALLED FEP RINGED GORE-TEX STRETCH VASCULAR GRAFT IN AN ABOVE-KNEE FEMOROPOPLITEAL BYPASS PROCEDURE. IT WAS REPORTED THAT THERE WAS AN ANASTOMOTIC PSEUDOANEURYSM THAT DEVELOPED IN THE GROIN POSTOPERATIVELY WITHIN 11 MONTHS AFTER IMPLANTATION. THIS WAS TREATED BY ANEURYSMECTOMY AND INTERPOSITION USING A 6MM THIN-WALLED FEP RINGED GORE-TEX STRETCH VASCULAR GRAFT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FEP RINGED GORE-TEX STRETCH VASCULAR GRAFT NONE DSY W.L. GORE & ASSOCIATES WLG402

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention