Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

Paraskevaidis, Stylianos; Konstantinou, Dimitrios; Vassilikos, Vassilios; Theofilogiannakos, Efstratios K.; Mantziari, Lilian; Megarisiotou, Athanasia; Galitsianos, Ioannis; Karvounis, Charalambos

doi:10.1155/2014/949785

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…In agreement with our study, Andrzej et al , [11], also found that the most common indication for TLE was an infection. Similarly, indications of extraction in Stylianos P et al , [12] study was an infection in 69.4% of the patients and led dysfunction in 30.6% of the patients. While in the EHRA survey 2012, the infection was the indication in 70% of the patients and non-infective indications in 30% of the patients [10].…”

Section: Discussionmentioning

confidence: 88%

“…In our study, older leads were associated with significantly prolonged procedure time compared to other leads (P-value < 0.001) and associated with a higher incidence of complications of TLE with a P-value 0.011 with no effect on patient outcome. However, Stylianos et al, a study [12], [15] noted that lead age per se did not hurt lead extraction success rate or occurrence of complications.…”

Section: Discussionmentioning

confidence: 99%

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Transvenous Lead Extraction of Cardiac Implantable Electronic Devices Indications, Complications and Outcome: An Egyptian Two Years' Experience

El-Zoghby¹,

Nawar²,

Soliman³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND:The growing needs to extract cardiovascular implantable electronic devices warrants the need to improve the outcome and prevent complications.AIM:This study aims to analyse the findings and identify factors associated with complications of Percutaneous Transvenous Lead Extraction in the Critical Care Department, Cairo University.METHODS:We studied 52 candidates for Percutaneous Transvenous Lead extraction of a Permanent Pace Maker (PPM) regarding extraction indications, comorbidities, device type, complications and outcome. Extraction was first attempted by simple manual traction using regular non-locking stylet and if failed, locking stylet, and evolution dilator sheath were used.RESULTS:We extracted 110 leads with a mean lead age of 4.67 ± 3.6 years. The most common extraction indication was an infection (71.15%). Indications correlated significantly with comorbidities (p = 0.024), the most common being Diabetes Mellitus (40.38%). Simple traction was successful in 31 % of the leads, while 69% were extracted using locking stylet and evolution dilator sheath. The method of lead extraction correlated significantly with lead age (P ≤ 0.001). Complications were significantly higher with extraction by evolution dilator sheaths than by simple traction (P = 0.003) and in older patients (P = 0.008). Complications also correlated significantly with extractions indications (p = 0.012), type of PPM (P = 0.037), number of extracted leads (P = 0.041), and lead age (p= 0.011).CONCLUSION:Among the studied variables, extraction indications particularly infection, was the only preventable factor significantly associated with complications. While focusing on preventable factors, improving, implantation and extraction techniques should also be addressed.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Transvenous Lead Extraction of Cardiac Implantable Electronic Devices Indications, Complications and Outcome: An Egyptian Two Years' Experience

El-Zoghby¹,

Nawar²,

Soliman³

et al. 2019

Open Access Maced J Med Sci

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“…Paraskevaidis et al [11] showed success rates above 90% using non-powered traction tools, with minimal complications. In a study that used laser-powered sheaths followed by mechanical tools, patients had complete extraction in more than 95% of the cases, with complications in less than 1% [12] .…”

Section: Discussionmentioning

confidence: 99%

Lead Removal Without Extraction Tools: A Single-Center Experience

Lima¹,

Cunha²,

Menezes³

et al. 2019

Braz J Cardiovasc Surg

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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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“…Mechanical sheaths are advanced over the lead and break fibrotic attachments between the lead and vein. 29 Beyond mechanical sheaths are laser sheaths. Laser sheaths use circumferential fiber-optic cables to transmit laser light and disrupt the fibrotic attachments.…”

Section: Lead Extractionmentioning

confidence: 99%

Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices

Bhatia

Safavi‐Naeini²,

Razavi³

et al. 2017

Semin Cardiothorac Vasc Anesth

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Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult. As the indications for CIEDs expands and with the continuing evolution of these devices, the number of patients requiring explantation for device recall, malfunction, and infection continues to increase. In this manuscript, we review the most common CIEDs, the indications and process of lead removal/device explantation, potential complications associated with the procedure and the anesthetic management of these patients.

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Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

Cited by 5 publications

References 10 publications

Transvenous Lead Extraction of Cardiac Implantable Electronic Devices Indications, Complications and Outcome: An Egyptian Two Years' Experience

Transvenous Lead Extraction of Cardiac Implantable Electronic Devices Indications, Complications and Outcome: An Egyptian Two Years' Experience

Lead Removal Without Extraction Tools: A Single-Center Experience

Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices

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