FDA Adverse Event Injury Summary report: N

TALENT ABDOMINAL STENT GRAFT SYSTEM - HYDRO

MDR report key: 1933748 · Received December 16, 2010

Report

Report Number
2953200-2010-02562
Event Type
Injury
Date Received
December 16, 2010
Date of Event
November 17, 2010
Report Date
November 17, 2010
Manufacturer
MEDTRONIC CARDIOVASCULAR GALWAY
Product Code
MIH
PMA / PMN Number
P070027
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION: RESULTS: (ENDOLEAK) AND (UNK CAUSE OF ENDOLEAK). CONCLUSIONS: (UNK CAUSE OF ENDOLEAK).

Description of Event or Problem · 1

AN ANEURX STENT GRAFT SYSTEM WAS IMPLANTED IN A PT FOR THE ENDOVASCULAR TREATMENT OF AN ABDOMINAL AORTIC ANEURYSM APPROX 27 MONTHS AGO. ANEURYSM AND VESSEL MORPHOLOGY AT THE TIME OF IMPLANT WERE NOT REPORTED. THE ILIAC ARTERIES WERE ANEURYSMAL. IT WAS REPORTED THAT DURING A ROUTINE F/U A DISTAL TYPE 1 ENDOLEAK ON THE RIGHT SIDE WAS SEEN. THE ILIAC ANEURYSM HAD DEVELOPED AROUND THE DISTAL PORTION OF THE CONTRALATERAL LIMB AND RESULTED IN LOSS OF SEAL (SEE MFR # 2953200-2010-02561). THE ILIAC ANEURYSM WAS ATTRIBUTED TO DISEASE PROGRESSION. THE DECISION WAS MADE TO EMBOLIZE THE RIGHT HYPOGASTRIC ARTERY AND EXTEND WITH A TALENT LIMB. AFTER THE TALENT LIMB WAS IMPLANTED THERE WAS A SMALL PIN HOLE THAT RESULTED IN A TYPE 3 ENDOLEAK. THE TALENT LIMB WAS RELINED WITH AN ADDITIONAL STENT GRAFT AND SUCCESSFULLY RESOLVED THE ENDOLEAK. NO ADDITIONAL CLINICAL SEQUELAE WERE REPORTED, AND THE PT IS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TALENT ABDOMINAL STENT GRAFT SYSTEM - HYDRO MIH MEDTRONIC CARDIOVASCULAR GALWAY NA V00481718

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention