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Laser extraction of entrapped leads
V Parsonnet1, M Roelke, A Trivedi
1Division of Surgical Research, Newark Beth Israel Medical Center, 201 Lyons Avenue, Newark, NJ, USA.Vpace@aol.com
Pacing and Clinical Electrophysiology : PACE
|April 20, 2001
Summary
The excimer laser extractor simplifies removing entrapped pacemaker and defibrillator leads. While effective, this procedure carries risks, including serious complications requiring emergency intervention.
Area of Science:
- Cardiovascular medicine
- Medical devices
- Surgical technology
Background:
- Pacemaker and defibrillator leads can become entrapped, complicating removal.
- Traditional lead extraction methods carry risks and may be less effective for complex cases.
Purpose of the Study:
- To evaluate the safety and efficacy of the excimer laser extractor for removing entrapped leads.
- To report on complication rates and outcomes associated with laser-assisted lead extraction.
Main Methods:
- A retrospective review of 62 lead extraction procedures using the excimer laser extractor.
- Analysis of successful removal rates, retained lead portions, and intra-procedural complications.
Main Results:
- Sixty-two leads were successfully removed, with portions remaining in 10 cases.
- Two serious complications occurred: superior vena cava tear and atrial tear, both managed successfully via emergency sternotomy.
Conclusions:
- The excimer laser extractor significantly simplifies the removal of entrapped leads.
- Despite advancements, lead extraction remains a procedure with potential for serious complications, necessitating preparedness for emergent management.