Introduction
Indications for cardiac devices have been increasing as well as the need for
lead extractions as a result of infections, failed leads and device recalls.
Powered laser sheaths, with a global trend towards the in-creasingly
technological tools, meant to improve the procedure’s outcome but have
economic implications.
Objective
The aim of this study is to demonstrate the experience of a Bra-zilian center
that uses simple manual traction in most lead removals per-formed annually,
questioning the real need for expensive and technically challenging new
devices.
Methods
This retrospective observational study included 35 patients who had a
transvenous lead extraction in the period of a year between January 1998 and
October 2014 at Hospital de Messejana Dr. Carlos Alberto Studart Gomes, in
Fortaleza, CE, Brazil. Data were collected through a records review. They
were evaluated based on age, type of device, dwelling time, indication for
removal, technique used and immediate outcomes.
Results
The median dwelling time of the devices was 46.22 months. Infec-tion, lead
fracture and device malfunction were the most common indica-tions. Simple
traction was the method of choice, used in 88.9% of the pro-cedures. Manual
traction presented high success rates, resulting in com-plete removal
without complications in 90% of the cases.
Conclusion
This article suggests that lead extraction by simple manual traction can
still be performed effectively in countries with economic diffi-culties as a
first attempt, leaving auxiliary tools for a second attempt in case of
failure or contraindications to the simple manual traction technique.
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