Letter to the editor: Difficult removal of exposed peripheral nerve stimulator leads: a report of 2 cases

Bajaj, Harnek S.; Lester, Denise; Trainer, Robert

doi:10.1097/pr9.0000000000000994

Cited by 1 publication

(1 citation statement)

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“…Despite its significance, the removal of neuromodulation leads is not widely reported. To the authors’ knowledge, multiple case reports and letters to the editor have been used to underscore clinical phenomena associated with the removal process [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. These studies discuss procedural safety and efficacy but do not characterize the mechanisms, mechanical forces, or conditions associated with the device removal process in which local tissue invariably experiences trauma.…”

Section: Introductionmentioning

confidence: 99%

Removal Forces of a Helical Microwire Structure Electrode

Howe,

Chen,

Golobish

et al. 2024

Bioengineering

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(1) Background: Medical devices, especially neuromodulation devices, are often explanted for a variety of reasons. The removal process imparts significant forces on these devices, which may result in device fracture and tissue trauma. We hypothesized that a device’s form factor interfacing with tissue is a major driver of the force required to remove a device, and we isolated helical and linear electrode structures as a means to study atraumatic removal. (2) Methods: Ductile linear and helical microwire structure electrodes were fabricated from either Gold (Au) or Platinum–Iridium (Pt-Ir, 90-10). Removal forces were captured from synthetic gel models and following chronic implantation in rodent and porcine models. Devices were fully implanted in the animal models, requiring a small incision (<10 mm) and removal via tissue forceps. (3) Results: Helical devices were shown to result in significantly lower maximal removal forces in both synthetic gel and rodent studies compared to their linear counterparts. Chronically (1 yr.), the maximal removal force of helical devices remained under 7.30 N, for which the Platinum–Iridium device’s tensile failure force was 32.90 ± 2.09 N, resulting in a safety factor of 4.50. (4) Conclusions: An open-core helical structure that can freely elongate was shown to result in reduced removal forces both acutely and chronically.

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