GORE VIATORR? TIPS ENDOPROSTHESIS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-05-03 for GORE VIATORR? TIPS ENDOPROSTHESIS manufactured by W.l. Gore & Associates.

Event Text Entries

[44336542] Lopera je, speeg kv, young c, et al. Segmental liver ischemia / infarction after elective transjugular intrahepatic portosystemic shunt creation: clinical outcomes in 10 patients. Journal of vascular & interventional radiology 2015;26(6):835-841. No additional information was provided by the author.
Patient Sequence No: 1, Text Type: N, H10


[44336543] This information was received through literature article " segmental liver ischemia / infarction after elective transjugular intrahepatic portosystemic shunt creation: clinical outcomes in 10 patients" published in journal of vascular & interventional radiology, 2015. This article is a retrospective review of 10 patients who underwent elective tips creation between march 2006 and september 2014. Nine of the 10 patients received a gore viatorr tips endoprosthesis, and one patient received a wallstent device. The article does not clarify which patients received viatorr devices. The article reports "a patient who had received a liver transplant and had a large 40% liver infarct with associated thrombosis of the anterior branch of the right pv and middle and left hepatic veins developed a large area of necrosis, with subsequent biloma formation that required complex drainage interventions. " "this patient presented with fever and abdominal pain 10 days after the tips procedure. After percutaneous drainage of the collection, a large fistula with communication with the right biliary system was noted. The biliary fistula was finally controlled after embolization with coils and placement of a plastic biliary stent in the distal common bile duct. "
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2017233-2016-00433
MDR Report Key5625631
Date Received2016-05-03
Date of Report2016-04-08
Date of Event2015-06-01
Date Added to Maude2016-05-03
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMARCI STEWART
Manufacturer Street1500 N. 4TH STREET
Manufacturer CityFLAGSTAFF AZ
Manufacturer Phone9285263030
Manufacturer G1MEDICAL ECHO RIDGE B/P
Manufacturer Street3250 W. KILTIE LANE
Manufacturer CityFLAGSTAFF AZ 86005
Manufacturer CountryUS
Manufacturer Postal Code86005
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameGORE VIATORR? TIPS ENDOPROSTHESIS
Generic NameSHUNT, PORTOSYSTEMIC, ENDOPROSTHESIS
Product CodeMIR
Date Received2016-05-03
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerW.L. GORE & ASSOCIATES
Manufacturer AddressFLAGSTAFF AZ


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2016-05-03

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