Outcomes of patients requiring emergent surgical or endovascular intervention for catastrophic complications during transvenous lead extraction

Brunner, Michael; Cronin, Edmond M.; Wazni, Oussama; Baranowski, Bryan; Saliba, Walid; Sabik, Joseph F.; Lindsay, Bruce D.; Wilkoff, Bruce L.; Tarakji, Khaldoun G.

doi:10.1016/j.hrthm.2013.12.004

Cited by 142 publications

(120 citation statements)

References 19 publications

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“…31 System extraction is associated with a small risk of major complications, particularly vascular lacerations causing haemothorax and death. 32,70,[79][80][81][82] Extraction-related mortality rates are 0.1-0.8 % in large experienced centres. 70,83 In one large, single-centre study, including more than 5,000 lead extractions, 43 % of which were due to infection, risk of major complications was 1.8 %, and minor complications 3.6 %.…”

Section: Outcomes Of Cardiac Implantable Electronic Device Infectionmentioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

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Cardiac implantable electronic device (CIED) infection is an increasing problem. Reasons for this are uncertain, but likely relate to an increasing proportion of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices implanted, as well as implantations in ‘higher risk’ candidates, i.e. patients with heart failure, diabetes and renal failure. Challenges within the field of CIED infections are multiple with prevention being the most important challenge. Careful prescription of CIED treatment and careful patient preparation before implantation is important. Diagnosis is often difficult and delayed by subtle signs of infection. Treatment of CIED infection includes complete system removal in centres experienced in CIED extraction and prolonged antibiotic therapy. Meticulous planning and preparation before system extraction and later CIED re-implantation is essential for better patient outcome. Future strategies for reducing CIED infection should be tested in sufficiently powered, multicentre, randomised controlled trials

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Section: Outcomes Of Cardiac Implantable Electronic Device Infectionmentioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

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“…Most of the data pertaining to the safety and efficacy of TLR originated from specialized centers with extensive experience. [3][4][5] …”

mentioning

confidence: 99%

Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States

et al. 2015

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Background— Transvenous lead removal (TLR) has made significant progress with respect to innovation, efficacy, and safety. However, limited data exist regarding trends in use and adverse outcomes outside the centers of considerable experience for TLR. The aim of our study was to examine use patterns, frequency of adverse events, and influence of hospital volume on complications. Methods and Results— Using the Nationwide Inpatient Sample, we identified 91 890 TLR procedures. We investigated common complications including pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with TLR, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. We specifically assessed in-hospital death (2.2%), hemorrhage requiring transfusion (2.6%), vascular complications (2.0%), pericardial complications (1.4%), open heart surgery (0.2%), and postoperative respiratory failure (2.4%). Independent predictors of complications were female sex and device infections. Hospital volume was not independently associated with higher complications. There was a significant rise in overall complication rates over the study period. Conclusions— The overall complication rate in patients undergoing TLR was higher than previously reported. Female sex and device infections are associated with higher complications. Hospital volume was not associated with higher complication rates. The number of adverse events in the literature likely underestimates the actual number of complications associated with TLR.

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“…[8] In the case of venous stenting, for its function and vascular condition the best solution is no leads in the vessel, and if they are present already, the best option is to introduce them by using a femoral or epicardial approach. [9] Although more data and reporting of outcomes are required for confirmation, conclusions from the initial observations seem generally optimistic.…”

Section: Discussionmentioning

confidence: 99%

Successful removal of stented leads by using percutaneous approach

Jonik¹,

Grabowski²,

Pietura³

et al. 2017

Heart Beat

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Background: Nowadays we are implanting more cardiac implantable electronic device (CIED) systems with intracardiac leads. Unfortunately, sometimes when the lead remains in the vessel too long it adheres to its wall, causing venous occlusion, and the removal is problematic. Venous occlusion is treated with venoplasty with the stent remaining. The standards clearly recommend removing all leads before venoplasty and stenting. Stenting of leads into the vessel wall makes them practically indelible. In the literature, we found only one report of successful removal of veno-thoracic stented leads.

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Outcomes of patients requiring emergent surgical or endovascular intervention for catastrophic complications during transvenous lead extraction

Cited by 142 publications

References 19 publications

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States

Successful removal of stented leads by using percutaneous approach

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