FDA Adverse Event Injury Summary report: N

ENDURANT ABDOMINAL STENT GRAFT

MDR report key: 2181396 · Received July 21, 2011

Report

Report Number
2953200-2011-01305
Event Type
Injury
Date Received
July 21, 2011
Date of Event
November 10, 2015
Report Date
November 15, 2015
Manufacturer
MEDTRONIC CARDIOVASCULAR IRELAND
Product Code
MIH
PMA / PMN Number
P100021
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
PHYSICIAN
Health Professional
N

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION, RESULTS: (ENDOLEAK). RESULTS AND CONCLUSIONS: (90 DEGREE ANGULATED NECK).

Description of Event or Problem · 1

AN ENDURANT STENT GRAFT SYSTEM WAS IMPLANTED IN A PATIENT FOR THE ENDOVASCULAR TREATMENT OF A 3.0 CM ILIAC ANEURYSM. VESSEL MORPHOLOGY WAS REPORTED AS MILD TORTUOSITY; MILD PROXIMAL NECK CALCIFICATION; MILD NECK THROMBUS; MODERATE BILATERAL ILIAC CALCIFICATION; AORTIC NECK DIAMETER OF 22 - 23 MM OVER A 2.5 CM LENGTH; AND A 90 DEGREE AORTIC NECK ANGULATION. AFTER IMPLANTATION, THERE WAS A PROXIMAL TYPE I ENDOLEAK. AN INTERNAL REVIEW OF FILMS CONFIRMS A LIKELY TYPE I ENDOLEAK WITH A MUCH ANGULATED NECK. NO CLINICAL SEQUELAE WERE REPORTED AND THE PATIENT WILL BE MONITORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDURANT ABDOMINAL STENT GRAFT MIH MEDTRONIC CARDIOVASCULAR IRELAND NA V00881924

Patients

Seq Age Sex Outcome Treatment
1 96 YR Female UNK.