Usefulness of mechanical transvenous dilation and location of areas of adherence in patients undergoing coronary sinus lead extraction

Abstract

Our study suggests that CS leads, after medium-term implantation, can be effectively and safely removed using MD with polypropylene sheaths, in the case of unsuccessful LT. No pre-operative elements predictive of LT failure could be identified. Areas of adherence were rarely located in the CS or its tributaries.

Extraction of Implantable Cardiac Electronic Devices

“…Of the four cases requiring laser extraction, three required laser application within the CS (1 proximal CS and 2 distal CS) with no complications reported. Bongiorni et al [25] reported on a larger cohort of 37 CS lead extractions. The age of the CS leads in this study was 19.5±16.5 months.…”

Extraction of an Infected Active Fixation Coronary Sinus Lead with the Aid of a Tissue Stabilizer

“…Furthermore, as showed by venography also in the present case, this particular lead is often associated with a signifi cant thrombotic reaction with chronic occlusion of the CS vein branch and lead entrapment [5]. Cronin et al described CS vein occlusion and fi brotic adhesions between polyurethane lobes and CS endothelium as an important mechanism making transvenous lead extraction extremely diffi cult and preventing implantation of a new lead in the same CS vein branch [6].…”

“…While deployment and removal of such lead has been reported to be achieved successfully in the acute setting [3], information regarding both function of the fi xation mechanism and easiness of lead removal in the long-term are limited [3]. As shown previously [5] transvenous extraction of the StarFix™ lead may be extremely challenging requiring complex mechanical dilatation techniques in order to completely remove it without fracturing and dislodgement of the polyurethane lobes.…”

Chronic lead malposition diagnosis and management: discussion of two cases and literature review

“…The largest study to date by Bongiorni et al. , reported on 37 patients. The longest CS lead had been in situ for 84 months.…”