Description of Event or Problem · 1
THE TURBOHAWK DEVICE WAS PLACED OVER A WIRE AND POSITIONED IN THE LEFT SFA(SUPERFICIAL FEMORAL ARTERY) - POPLITEAL ARTERY. THE SURGEON USED THE DEVICE TO MAKE ONE PASS THROUGH THE LESION AND NOTED TROUBLE MOVING THE DEVICE OVER THE WIRE. "THIS PROVED SOMEWHAT DIFFICULT, BUT EVENTUALLY A STIFF WIRE WAS ADVANCED ACROSS THIS FOLLOWED BY A 4-FRENCH GLIDE CATHETER. AN EMBOLIC PROTECTION DEVICE, 5 MM IN DIAMETER WAS DEPLOYED AT ABOUT THE LEVEL OF THE LEFT KNEE. NEXT, ATTEMPTS WERE MADE TO PASS THE TURBOHAWK CALCIUM CUTTING DEVICE TO THE REGION OF FUNCTIONAL OCCLUSION. THIS DEVICE WOULD NOT TRAVERSE THE LESION. THEREFORE, A 3.5-MM X 4-CM BALLOON WAS ADVANCED OVER THE PROTECTION WIRE AND INFLATED FOR PREDILATATION. THIS WAS FOLLOWED BY THE ATHERECTOMY DEVICE. THE ATHERECTOMY DEVICE MADE SEVERAL PASSES IN THE REGION. I SHOULD NOTE THAT PRIOR TO PASSING THE ATHERECTOMY DEVICE AND AFTER INFLATING THE BALLOON, THERE WAS SOME IMPROVEMENT IN THE APPEARANCE OF THIS REGION, ALTHOUGH THERE REMAINED A 50% RESIDUAL STENOSIS WHICH WAS TO BE TREATED WITH THE ATHERECTOMY DEVICE. AFTER MULTIPLE PASSAGES OF THE ATHERECTOMY DEVICE WERE MADE, ATTEMPTS WERE MADE TO RETRIEVE IT FOR CLEANING. AT THIS POINT, THE DEVICE WOULD NOT RE-ENTER THE SHEATH PROPERLY AND AFTER A GREAT DEAL OF MANIPULATION, THE DEVICE DID GET INTO THE SHEATH, BUT APPEARED TO BECOME SEPARATED WITHIN THE SHEATH AND COULD NOT BE WITHDRAWN. AT THIS POINT, OUR ONLY OPTION WAS TO REMOVE THE ENTIRE SYSTEM AS A UNIT, INCLUDING THE SHEATH, ATHERECTOMY DEVICE, AND EMBOLIC PROTECTION DEVICE. THIS WAS ALL WITHDRAWN WITHOUT DIFFICULTY. UNFORTUNATELY AT THIS POINT, ACCESS WAS LOST, HEPARIN WAS REVERSED, AND PRESSURE APPLIED IN THE RIGHT GROIN. THERE WAS NO HEMATOMA OR OBVIOUS ACCESS SITE COMPLICATION. DOPPLER SIGNALS AT THE LEFT ANKLE WERE SOMEWHAT IMPROVED WHEN COMPARED TO THE PRE INTERVENTION SIGNALS. COMPLETION ANGIOGRAPHY AGAIN COULD NOT BE PERFORMED BECAUSE ACCESS WAS LOST IN WITHDRAWING THE DEVICE WHICH HAD MALFUNCTIONED."