FDA Adverse Event Injury Summary report: N

PROMUS ELITE

MDR report key: 20024013 · Received August 22, 2024

Report

Report Number
2124215-2024-49928
Event Type
Injury
Date Received
August 22, 2024
Date of Event
July 19, 2024
Report Date
September 19, 2024
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NIQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

E1: INITIAL REPORTER ADDRESS 1: (B)(6).

Additional Manufacturer Narrative · 0

E1: INITIAL REPORTER ADDRESS 1: (B)(6).

Description of Event or Problem · 0

IT WAS REPORTED THAT A DISSECTION OCCURRED. THE TARGET LESION WAS LOCATED IN THE RIGHT CORONARY ARTERY. A 3.00 X 24 MM PROMUS ELITE WAS DEPLOYED AND POST DILATED AND A PROXIMAL EDGE FLOW-LIMITING DISSECTION WAS NOTED. THE DISSECTION WAS COVERED WITH A 3.50 X 13 MM NON-BOSTON SCIENTIFIC (BSC) STENT AND THE PROCEDURE WAS COMPLETED SUCCESSFULLY. THE PATIENT WAS STABLE AFTER THE PROCEDURE AND FULLY RECOVERED. IT WAS FURTHER REPORTED THAT THE 90% STENOSED TARGET LESION WAS LOCATED IN THE SEVERELY TORTUOUS AND MODERATELY CALCIFIED RIGHT CORONARY ARTERY. A 2.5 X 15 MM SEMI-COMPLIANT BALLOON WAS UTILIZED TO PRE-DILATE THE LESION, FOLLOWED BY FULL DEPLOYMENT OF THE STENT UPON BALLOON INFLATION. THIS WAS SUCCEEDED BY POST-DILATION USING A 3.5 X 12 MM NON-COMPLIANT BALLOON.

Description of Event or Problem · 0

IT WAS REPORTED THAT A DISSECTION OCCURRED. THE TARGET LESION WAS LOCATED IN THE RIGHT CORONARY ARTERY. A 3.00 X 24 MM PROMUS ELITE WAS DEPLOYED AND POST DILATED AND A PROXIMAL EDGE, FLOW-LIMITING DISSECTION WAS NOTED. THE DISSECTION WAS COVERED WITH A 3.50 X 13 MM NON-BOSTON SCIENTIFIC (BSC) STENT AND THE PROCEDURE WAS COMPLETED SUCCESSFULLY. THE PATIENT WAS STABLE AFTER THE PROCEDURE AND FULLY RECOVERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2272426 PROMUS ELITE STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC CORPORATION 10674 0031490937

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention