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Li X, Feng Y, Gong Y, Chen Y. Assessing the Reproducibility of Research Based on the Food and Drug Administration Manufacturer and User Facility Device Experience Data. J Patient Saf 2024; 20:e45-e58. [PMID: 38470959 DOI: 10.1097/pts.0000000000001220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This article aims to assess the reproducibility of Manufacturer and User Facility Device Experience (MAUDE) data-driven studies by analyzing the data queries used in their research processes. METHODS Studies using MAUDE data were sourced from PubMed by searching for "MAUDE" or "Manufacturer and User Facility Device Experience" in titles or abstracts. We manually chose articles with executable queries. The reproducibility of each query was assessed by replicating it in the MAUDE Application Programming Interface. The reproducibility of a query is determined by a reproducibility coefficient that ranges from 0.95 to 1.05. This coefficient is calculated by comparing the number of medical device reports (MDRs) returned by the reproduced queries to the number of reported MDRs in the original studies. We also computed the reproducibility ratio, which is the fraction of reproducible queries in subgroups divided by the query complexity, the device category, and the presence of a data processing flow. RESULTS As of August 8, 2022, we identified 523 articles from which 336 contained queries, and 60 of these were executable. Among these, 14 queries were reproducible. Queries using a single field like product code, product class, or brand name showed higher reproducibility (50%, 33.3%, 31.3%) compared with other fields (8.3%, P = 0.037). Single-category device queries exhibited a higher reproducibility ratio than multicategory ones, but without statistical significance (27.1% versus 8.3%, P = 0.321). Studies including a data processing flow had a higher reproducibility ratio than those without, although this difference was not statistically significant (42.9% versus 17.4%, P = 0.107). CONCLUSIONS Our findings indicate that the reproducibility of queries in MAUDE data-driven studies is limited. Enhancing this requires the development of more effective MAUDE data query strategies and improved application programming interfaces.
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Affiliation(s)
- Xinyu Li
- From the Department of Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Yubo Feng
- From the Department of Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Yang Gong
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas
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Ahrari A, Healy GM, Min A, Alkhalifah F, Oreopoulos G, Teng Tan K, Jaberi A, Rajan DK, Mafeld S. Real-World Experience With the Angio-Seal Closure Device: Insights From Manufacturer and User Facility Device Experience Database. J Endovasc Ther 2023:15266028231219226. [PMID: 38110358 DOI: 10.1177/15266028231219226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
PURPOSE Angio-Seal (Terumo Medical Corporations, Somerset, New Jersey) device is indicated for femoral arteriotomy closure. Real-world published data on complications are limited. We present 1 year of safety events involving Angio-Seal from the US Food and Drug Administration's post-market surveillance database of Manufacturer and User Facility Device Experience (MAUDE). Steps for managing frequent device-related problems are discussed. MATERIALS AND METHODS Angio-Seal MAUDE data from November 2019 to December 2020 was classified according to (1) mode of device failure, (2) complication, (3) treatment, and (4) Cardiovascular and Interventional Radiological Society of Europe (CIRSE) adverse event classification system. RESULTS There were 715 safety events, involving Angio-Seal VIP (93.1%), Evolution (5.7%), STS Plus (1.1%), and sizes 6F (62.5%) and 8F (37.5%). Failure mode involved unrecognized use of a damaged device (43.4%), failed deployment (20.1%), failed arterial advancement (6.3%), detachment of device component (4.9%), failed retraction (3.6%), operator error (1.1%), and indeterminate (20.6%). Of total, 44.8% of events were associated with patient harm. Complications involved minor blood loss (34.1%), hematoma (5.6%), significant blood loss (1.4%), and pseudoaneurysm (1.4%). Of total, 43.3% of cases required manual compression (MC), whereas 8.8% required more advanced intervention. Interventions included surgical repair (49.2%), thrombin injection (9.5%), balloon tamponade (6.3%), covered stent (4.8%), and unspecified (30.2%). Majority of safety events were CIRSE grade 1 (92.0%), followed by grades 2 (3.1%), 3 (4.6%), and 6 (deaths, 0.3%). Minority of devices were returned for manufacturer analysis (27.8%). CONCLUSIONS The majority of safety events were associated with minor blood loss or local hematoma and could be addressed with MC alone. Most events were attributed to damaged device; however, very few devices were returned to manufacturer for analysis. This should be encouraged to allow for root cause analysis in order to improve safety profile of devices. System-level strategies for addressing barriers to under-reporting of safety events may also be considered. CLINICAL IMPACT Our study highlights important safety events encountered in real-world practice with Angio-Seal closure device. The MAUDE database captures real-world device malfunctions not typically appreciated in conventional clinical trials. Our study provides valuable insight for clinician-users on anticipating and managing the most common device malfunctions. Additionally, our data provide feedback for manufactures to optimize product design and direct manufacturer user training to improve safety. Finally, we hope that the study promotes system-level strategies that foster reporting of safety events and undertaking of root cause analysis.
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Affiliation(s)
- Aida Ahrari
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - Gerard M Healy
- Department of Radiology, St Vincent's University Hospital, Dublin, Ireland
| | - Adam Min
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - Fahd Alkhalifah
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - George Oreopoulos
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
- Division of Vascular Surgery, University Health Network, Toronto, ON, Canada
| | - Kong Teng Tan
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - Arash Jaberi
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - Dheeraj K Rajan
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
| | - Sebastian Mafeld
- Department of Radiology, University of Toronto, Toronto, ON, Canada
- Joint Department of Medical Imaging, University Health Network and Sinai Health System, Toronto, ON, Canada
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Lim Y, Wulkan A, Avram M. FDA MAUDE database reported adverse events on noninvasive body contouring, cellulite treatment, and muscle stimulation from 2015 to 2021. Lasers Surg Med 2023; 55:146-151. [PMID: 35916105 DOI: 10.1002/lsm.23592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Noninvasive cosmetic procedures have continued to gain popularity, owing to their short, in-office treatments combined with little to no downtime. These procedures are also highly accessible, even offered at medical spas by nonphysician operators. The coronavirus disease 2019 (COVID-19) pandemic also saw heightened interest in all cosmetic procedures, presumably as social distancing and stay-at-home orders allotted time and space for postop recovery. As the market for these procedures expand, a thorough understanding of potential adverse events is critical for providers to better counsel their patients on risks and expectations when obtaining informed consent. MATERIALS AND METHODS We employed the Food and Drug Administration (FDA's) Manufacturer and User Facility Device Experience (MAUDE) database (http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm), which compiles medical device reports (MDRs) for suspected injuries from device use or malfunction, submitted by manufactures and operators. We focused our query on three main categories: noninvasive body contouring, cellulite treatments, and muscle stimulation therapies that utilize electromagnetic energy. The query was performed in February 2022 using a comprehensive list of product names and manufacturers. RESULTS The initial search yielded 827 MDRs, which were individually reviewed for duplicate reports or insufficient data. Ultimately, 723 MDRs were analyzed (660 for noninvasive body contouring, 55 for cellulite treatment, and 8 for muscle stimulation). Paradoxical hyperplasia accounted for the majority of MDRs for noninvasive body contouring, while burns and scars were most common for muscle stimulation and cellulite treatments, respectively. Of the 7-year span we surveyed, 2021 accounted for 515 of the 723 total assessed MDRs (71.2%), the majority of which were from cryolipolysis procedures. CONCLUSION The MAUDE database remains an essential tool to monitor potential adverse events of medical devices, including those utilized for noninvasive, cosmetic procedures. Insight from the MAUDE database can be clinically translated when discussing treatment options with patients, helping to optimize patient safety and satisfaction.
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Affiliation(s)
- Young Lim
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Adam Wulkan
- Department of Dermatology, Lahey Clinic, Burlington, Massachusetts, USA.,Laser and Cosmetic Dermatology, Lahey Clinic, Burlington, Massachusetts, USA
| | - Mathew Avram
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Metikala S, Mahmoud K, O'Connor KM, Chao W, Wapner KL, Farber DC. Adverse Events Related to Cartiva Hemiarthroplasty of First Metatarsal: An Analysis of Reports to the United States Food and Drug Administration. Foot Ankle Spec 2022; 15:113-118. [PMID: 32723089 DOI: 10.1177/1938640020943715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The results supporting Cartiva, a synthetic cartilage implant (Wright Medical) in hallux rigidus have come from limited institutions creating observational bias. Complications experienced in community centers are not routinely included in the published literature. To look at a broader range of potential complications, we reviewed the United States Food and Drug Administration's (FDA) voluntary device database and compared that data with published literature. Methods: The Manufacturer and User Facility Device Experience (MAUDE) database of the FDA was retrospectively reviewed between July 2016 and October 2019 using the product code: PNW, assigned for Cartiva. Results: A total of 49 events have been reported and implant subsidence was the most common with 16 reports. Others include fragmentation (9), infection (4), bone erosion (3), foreign body reaction (1) and unspecified (16). Thirty-five events mentioned further surgeries at a mean interval of 4.75 months. Conclusions: The analysis of the MAUDE database disclosed certain device-related dysfunctions that have been underreported in the published literature. Because of the voluntary nature of reporting, the true incidence of each complication is unknown with this data representing a baseline. The MAUDE database could be further strengthened by a more robust reporting mechanism or mandatory reporting of device-related complications.Levels of Evidence: Level IV: Case series from large database analysis.
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Affiliation(s)
- Sreenivasulu Metikala
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Karim Mahmoud
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kathryn M O'Connor
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Wen Chao
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Keith L Wapner
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Daniel C Farber
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Akoh CC, Chen J, Kadakia R, Park YU, Kim H, Adams SB. Adverse events involving hallux metatarsophalangeal joint implants: Analysis of the United States Food and Drug Administration data from 2010 to 2018. Foot Ankle Surg 2021; 27:381-388. [PMID: 32505511 DOI: 10.1016/j.fas.2020.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/27/2020] [Accepted: 05/08/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevalence of osteoarthritis of the hallux metatarsophalangeal joint (MTPJ) is 1 in 40 people over the age of 50. Surgical treatment options for MTPJ arthritis include joint preservation, joint resurfacing, and arthrodesis. Hallux MTPJ implants have evolved over the past several decades, but are associated with various complications. The aim of this study was to examine the MAUDE database to determine reported adverse events for hallux MTPJ implants. MATERIALS AND METHODS The US Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database was reviewed from 2010 to 2018 to review voluntary reported adverse event reports for approved implants within the United States. We recorded the type of adverse event and excluded duplicate reports and those extracted from already published literature. RESULTS Among 64 reported hallux MTPJ implant adverse events, the most common modes of adverse events were component loosening (34%), infection (14.1%), component fracture (9.4%), inflammation (9.4%), and allergic reaction (7.8%). Regarding implant type, Cartiva SCI had the highest percentage of adverse events (23.4%), followed by Arthrosurface ToeMotion (20.3%), Ascension MGT (12.5%), Arthrosurface HemiCAP® (10.9%), Futura primus (9.4%), and Osteomed Reflexion (6.3%). There was an increase in reported adverse events after 2016. The MAUDE database does not report the total incidence of implant insertion. CONCLUSION Our study of the MAUDE database demonstrated that component loosening and infection are the most common modes of adverse events for hallux MTPJ implants. Cartiva accounted for one-fourth of the implant-related adverse events during our study period, followed by ToeMotion, and Ascension MGT implants. Continued reporting of adverse events will improve our understanding on short and long-term complications of various hallux MTPJ implants. LEVEL OF EVIDENCE Level IV; Case Series from Large Database Analysis; Treatment Study.
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Affiliation(s)
- Craig C Akoh
- Duke University Medical Center, Box 2887, Durham, NC 27710, United States.
| | - Jie Chen
- Duke University Medical Center, Box 2887, Durham, NC 27710, United States
| | - Rishin Kadakia
- Duke University Medical Center, Box 2887, Durham, NC 27710, United States
| | - Young Uk Park
- Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggido, Republic of Korea
| | - Hyongnyun Kim
- Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Samuel B Adams
- Duke University Medical Center, Box 2887, Durham, NC 27710, United States
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Afify E, Patel R, Elmetwally A, Al-Khaffaf H. Delayed Complication Secondary to Unsuccessful Deployment of the StarClose Device. Ann Vasc Surg 2021; 76:600.e1-600.e5. [PMID: 33905856 DOI: 10.1016/j.avsg.2021.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
The introduction of vascular closure devices (VCD) such as the StarClose device, has been an innovative step in interventional procedures. Earlier post-procedure ambulation, reduced hematoma formation, the time to hemostasis and the need for blood transfusion have been achievable.1 Few case reports describe complications following deployment of the StarClose device, resulting in acute ischemia. Here we present a unique case of unsuccessful deployment of the StarClose device in a patient following an elective right superficial femoral artery angioplasty, resulting in delayed deterioration of the patient's symptoms, necessitating surgery months after the initial intervention.
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Ziapour B, Zaepfel C, Iafrati MD, Suarez LB, Salehi P. A systematic review of the quality of cardiovascular surgery studies that extracted data from the MAUDE database. J Vasc Surg 2021; 74:1708-1720.e5. [PMID: 33600931 DOI: 10.1016/j.jvs.2021.01.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate opportunities and limitations of using the Manufacturer and User Facility Device Experience (MAUDE) database for cardiovascular surgery research, we analyzed the quality of studies having ever used MAUDE, in the field of cardiovascular surgery. METHODS We systematically searched the Cochrane Library, PubMed, EMBASE, and Google Scholar for randomized and nonrandomized studies, from inception to July 2019. Two authors evaluated the quality of the retrieved observational studies, according to the National Institutes of Health quality assessment tool for either case series or cross-sectional studies. These tools quantify the quality of case series and cohorts/cross-sectional studies, respectively, with nine and 14 queries. RESULTS Fifty-eight studies were included in the final qualitative review. Of 58 identified studies, 32 were case series, 8 were abstracts of case series, and 13 were reviews or case discussion with an included series from MAUDE. Also, five articles were cross-sectional studies. Of the 32 formal case series, 26 (81%) were found to have poor quality. The most common reasons for a poor quality designation included a lack of consecutive participants, undetermined comparability of participants, and undetermined follow-up adequacy. Only one out of five cross-sectional studies had fair quality; four others were evaluated as poor quality studies. CONCLUSIONS Cardiovascular surgery studies using the MAUDE database, whether case series or cross-sectional design, are mostly of poor quality. Their low quality is partly caused by poor study design, but mainly by intrinsic limitations to the MAUDE database: cases recruited are not consecutive; patient characteristics are not detailed enough to allow a meaningful comparison of patient characteristics between different patient entries; outcome measures are unclear; there is a limited follow-up; and time-to-event data are lacking. We conclude that the quality of cardiovascular surgery publications that rely on data from MAUDE could be improved if investigators were to extract all relevant data points from MAUDE entries, then apply standard quality assessment tools in compiling and reporting the data. MAUDE might be improved if it used medical case report standards during the process of reporting and indexing adverse events. To calculate the incidence rate of any adverse event, all event-free cases, as well as all adverse events in patients using a device, are required. Neither of these two variables is available in the MAUDE at the time of writing.
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Affiliation(s)
- Behrad Ziapour
- Department of General Surgery, Allegheny General Hospital, Pittsburgh, Pa
| | | | - Mark D Iafrati
- Division of Vascular Surgery, Cardiovascular Center at Tufts Medical Center, Boston, Mass
| | - Luis B Suarez
- Cardiovascular Center at Tufts Medical Center, Boston, Mass
| | - Payam Salehi
- Division of Vascular Surgery, Cardiovascular Center at Tufts Medical Center, Boston, Mass.
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Choi DH, Kim MJ, Yoo CJ, Park CW. Republished: Nitinol clip distal migration and resultant popliteo-tibial artery occlusion complicating access closure by the StarClose SE vascular closure system. J Neurointerv Surg 2016; 9:e5. [DOI: 10.1136/neurintsurg-2015-012257.rep] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/03/2022]
Abstract
Lower extremity ischemia following deployment of a vascular closure device for access site closure after a transfemoral endovascular procedure rarely occurs. A 68-year-old woman diagnosed with subarachnoid hemorrhage due to a ruptured anterior communicating aneurysm was treated by endovascular coil embolization. The StarClose SE device was deployed for right femoral arteriotomy closure. After 2 days, critical ischemia occurred on her right lower leg due to total occlusion of the popliteo-tibial artery. Emergent surgical embolectomy was performed and the nitinol clip of the StarClose device was captured in the lumen of the tibioperoneal trunk. Although StarClose is an extravascular closure system, intravascular deployment, distal migration, and resultant critical limb ischemia can occur.
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Choi DH, Kim MJ, Yoo CJ, Park CW. Nitinol clip distal migration and resultant popliteo-tibial artery occlusion complicating access closure by the StarClose SE vascular closure system. BMJ Case Rep 2016; 2016:bcr-2015-012257. [PMID: 27030445 DOI: 10.1136/bcr-2015-012257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Lower extremity ischemia following deployment of a vascular closure device for access site closure after a transfemoral endovascular procedure rarely occurs. A 68-year-old woman diagnosed with subarachnoid hemorrhage due to a ruptured anterior communicating aneurysm was treated by endovascular coil embolization. The StarClose SE device was deployed for right femoral arteriotomy closure. After 2 days, critical ischemia occurred on her right lower leg due to total occlusion of the popliteo-tibial artery. Emergent surgical embolectomy was performed and the nitinol clip of the StarClose device was captured in the lumen of the tibioperoneal trunk. Although StarClose is an extravascular closure system, intravascular deployment, distal migration, and resultant critical limb ischemia can occur.
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Affiliation(s)
- Dae Han Choi
- Department of Neurosurgery, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Myeong Jin Kim
- Department of Neurosurgery, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Chan Jong Yoo
- Department of Neurosurgery, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Cheol Wan Park
- Department of Neurosurgery, College of Medicine, Gachon University, Incheon, Republic of Korea
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Memon S, Ball TC. Central Pseudo-Aneurysm Formation Following Arterial Closure with a StarClose SE Device: When a StarClose Doesn't Completely Close. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:207-10. [PMID: 27026227 PMCID: PMC4819689 DOI: 10.12659/ajcr.896587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Vascular closure devices (VCDs) are frequently used for hemostasis with endovascular procedures by employing sutures or plug devices (using collagen or hydrogel) or through the use of a metal clip made of nickel and titanium, such as the StarClose SE device. In comparison to manual compression (MC), VCDs are associated with earlier time to discharge and ambulation, improved patient comfort, and better cost-effectiveness. CASE REPORT A 77-year-old man with history of ischemic cardiomyopathy with non-ST segment elevation myocardial infarction (NSTEMI) underwent diagnostic cardiac catheterization with deployment of a StarClose SE vascular closure device for hemostasis. Upon repeat access 4 days later for coronary intervention, retrograde sheath angiography revealed a pseudo-aneurysm emanating from the center of the StarClose clip. CONCLUSIONS A review of the literature shows VCDs to be non-inferior to MC, with an overall high success rate. Major and minor complications rates are comparable to those with MC, and pseudo-aneurysm is an infrequent complication.
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Affiliation(s)
- Sehrish Memon
- Department of Cardiovascular Medicine, Carilion Roanoke Memorial Hospital, Roanoke, VA, USA
| | - Timothy C Ball
- Department of Cardiovascular Medicine , Carilion Roanoke Memorial Hospital, Roanoke, VA, USA
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11
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Tremaine AM, Avram MM. FDA MAUDE data on complications with lasers, light sources, and energy-based devices. Lasers Surg Med 2015; 47:133-40. [PMID: 25655709 DOI: 10.1002/lsm.22328] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND OBJECTIVE It is essential for physicians to be fully informed regarding adverse events and malfunctions associated with medical devices that occur in routine practice. There is limited information on this important issue in the medical literature, and it is mostly based on initial studies and case reports. More advanced knowledge regarding device adverse events is necessary to guide physicians towards providing safe treatments. The FDA requires that manufacturers and device users submit medical device reports (MDRs) for suspected injuries from device use or malfunction. The database of MDRs, entitled Manufacturer and User Facility Device Experience (MAUDE) enables the FDA to monitor device performance and identify potential safety issues. STUDY DESIGN/MATERIALS AND METHODS We employed the following search strategy to identify reported adverse events. We searched the MAUDE electronic database on the FDA website in December 2013: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm We collected all reported cases between 1991 and December 2013. The search terms utilized included a comprehensive list of device manufacturers, specific product names, and the wavelengths/technology of the devices used in the field of dermatology. RESULTS Our search yielded 1257 MDRs. Forty-five MDRs were excluded due to insufficient data. The data is broken down into the adverse events observed, such as, but not limited to: blistering, burns, scarring, dyschromia, fat loss, and nerve palsy. The MDRs describe the adverse event and attempt to determine if it was related to device malfunction versus operator error. Radiofrequency devices, diode lasers, and intense pulsed light devices were the most commonly reported devices related to injuries. CONCLUSION 1257 MDRs, from a myriad of devices used in dermatology, have been reported to the FDA as of December 2013. Despite the underreporting of adverse events, the MAUDE database is an untapped resource of post-market surveillance of medical devices. The database can offer additional information, which combined with the initial device studies and published case reports from our colleagues, will help raise awareness and improve patient safety.
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Affiliation(s)
- Anne Marie Tremaine
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts; Laser Skin Care Center, Long Beach, 90807, California
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Closure of the Axillary Artery Puncture Site with StarClose System after Endovascular Interventions. J Vasc Interv Radiol 2014; 25:640-5. [DOI: 10.1016/j.jvir.2014.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 01/01/2014] [Accepted: 01/03/2014] [Indexed: 11/21/2022] Open
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Sheth RA, Walker TG, Saad WE, Dariushnia SR, Ganguli S, Hogan MJ, Hohenwalter EJ, Kalva SP, Rajan DK, Stokes LS, Zuckerman DA, Nikolic B. Quality improvement guidelines for vascular access and closure device use. J Vasc Interv Radiol 2013; 25:73-84. [PMID: 24209907 DOI: 10.1016/j.jvir.2013.08.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 08/15/2013] [Accepted: 08/16/2013] [Indexed: 12/17/2022] Open
Affiliation(s)
- Rahul A Sheth
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - T Gregory Walker
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - Wael E Saad
- Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan.
| | - Sean R Dariushnia
- Department of Interventional Radiology and Image-guided Medicine, Emory University, Atlanta, Georgia
| | - Suvranu Ganguli
- Division of Vascular Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray 290, Boston, MA 02114
| | - Mark J Hogan
- Section of Vascular and Interventional Radiology, Department of Radiology, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Eric J Hohenwalter
- Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin
| | - Sanjeeva P Kalva
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dheeraj K Rajan
- Department of Medical Imaging, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Leann S Stokes
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Darryl A Zuckerman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Boris Nikolic
- Department of Radiology, Stratton Medical Center, Albany, New York
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