Transvenous Lead Extraction Procedure—Indications, Methods, and Complications

Boarescu, Paul-Mihai; Roşian, Adela-Nicoleta; Roşian, Ştefan Horia

doi:10.3390/biomedicines10112780

Cited by 7 publications

(6 citation statements)

References 54 publications

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“…A percutaneous approach would be less invasive than a surgical approach but would only likely be successful if a balloon venoplasty was followed by stenting to prevent the tissue from recoiling, as witnessed in another case of SVCO [ 5 ]. This being the case, for a stent to be deployed the existing transvenous pacing lead would need to be extracted [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…One known complication of transvenous lead removal is tears to the SVC which can result in haemothorax or a pericardial effusion, with complete vascular lacerations often resulting in the need for urgent surgical intervention whilst carrying a large mortality risk of 50% [ 13 ]. This case was thought to carry a high risk of SVC compromise given that the leads were likely already adherent to the SVC as the site of obstruction.…”

Section: Discussionmentioning

confidence: 99%

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Pacemaker lead thrombosis – a rare cause of breathlessness

Kelly,

Davidson,

Griffiths

2024

Arch Clin Cases

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As the number of pacemaker insertions increases to manage numerous cardiac arrhythmias, the number of complications is also increasing as a result. More common complications such as infection and lead displacement are routinely discussed with patients before they undergo the procedure. However rare complications such as superior vena cava syndrome are not discussed during the consenting period. But they do occur, as seen in this case of a 69-year-old male. This fit and active man had a right-sided dual-chamber pacemaker inserted due to sinus node disease and presented 5 years later with symptoms suggestive of superior vena cava obstruction (SVCO). Despite anticoagulation and before surgical intervention could be performed, the patient developed a right-sided chylothorax which was drained. An autologous pericardial patch repair of the SVC and a thrombectomy of SVC clots was subsequently performed. This was only partially successful and the SVCO recurred. A low fatty chain diet was initiated to manage the chylothorax, which remains stable. This rare complication has left the patient with a small pleural effusion and chronic pleural thickening. They can still exercise with mild breathlessness. The management of such a complication, which requires the input of many specialists, is challenging and often does not completely resolve all symptoms. For this reason, superior vena cava obstruction should be considered as a risk during the consenting procedure for a pacemaker insertion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pacemaker lead thrombosis – a rare cause of breathlessness

Kelly,

Davidson,

Griffiths

2024

Arch Clin Cases

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“…The incidence of associated complications, especially pacemaker device infections, has been increasing 1 . Since the removal or extraction of cardiovascular implantable electronic device (CIED) is usually mandated if infection occurs 2 . However, there is a dispute about the optimal timing of device reimplantation following the infected CIED extraction 3 .…”

Section: Discussionmentioning

confidence: 99%

“… 1 Since the removal or extraction of cardiovascular implantable electronic device (CIED) is usually mandated if infection occurs. 2 However, there is a dispute about the optimal timing of device reimplantation following the infected CIED extraction. 3 Current practice standards support waiting between 72 h and 14 days before reimplanting a device.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous transvenous lead extraction and implantation of leadless cardiac pacemaker: A case report

2023

Clinical Case Reports

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Cardiovascular implantable electronic device (CIED) infection is a serious complication and remains the most common indication for transvenous lead extraction (TLE). In addition, there are serious challenges such as venous access occlusion and reinfection after extraction. Leadless pacemaker (LP) provides a safe and effective pacing option for patients with device‐related infections. We describe here a case of simultaneous transvenous lead extraction and leadless pacemaker implantation due to bilateral venous infection and pacing dependency.

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“…The location where TLE procedure is performed is less important than the immediate availability of cardiothoracic surgical intervention. The time to surgical intervention is the most important factor in preventing death due to a major complication; therefore, organizational conditions should ensure the possibility of performing an emergency sternotomy within 5-10 min from the onset of the first symptoms of major complication [13,14].…”

Section: Tle Organizations and Security Measuresmentioning

confidence: 99%

Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series

Boarescu

Popa²,

Trifan

et al. 2022

IJERPH

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Transvenous lead extraction (TLE) is regarded as the first-line strategy for the management of complications associated with cardiac implantable electronic devices (CIEDs), when lead removal is mandatory. The decision to perform a lead extraction should take into consideration not only the strength of the clinical indication for the procedure but also many other factors such as risks versus benefits, extractor and team experience, and even patient preference. TLE is a procedure with a possible high risk of complications. In this paper, we present three clinical cases of patients who presented different indications of TLE and explain how the procedures were successfully performed. In the first clinical case, TLE was necessary because of device extravasation and suspicion of CIED pocket infection. In the second clinical case, TLE was necessary because occlusion of the left subclavian vein was found when an upgrade to cardiac resynchronization therapy was performed. In the last clinical case, TLE was necessary in order to remove magnetic resonance (MR) non-conditional leads, so the patient could undergo an MRI examination for the management of a brain tumor.

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Transvenous Lead Extraction Procedure—Indications, Methods, and Complications

Cited by 7 publications

References 54 publications

Pacemaker lead thrombosis – a rare cause of breathlessness

Pacemaker lead thrombosis – a rare cause of breathlessness

Simultaneous transvenous lead extraction and implantation of leadless cardiac pacemaker: A case report

Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series

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