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Related Experiment Videos

Intravascular lead extraction using locking stylets, sheaths, and other techniques.

N E Fearnot1, H J Smith, L B Goode

  • 1Hillenbrand Biomedical Engineering Center, Purdue University, West Lafayette, Indiana 47907.

Pacing and Clinical Electrophysiology : PACE
|December 1, 1990
PubMed
Summary
This summary is machine-generated.

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Transvenous lead extraction is effective for removing chronic pacemaker leads, even in complex cases. Proper training and surgical backup ensure patient safety and successful outcomes, potentially avoiding open-heart surgery.

Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Interventional Cardiology

Background:

  • Septicemia and infection are common reasons for chronic pacemaker lead extraction.
  • Pacemaker lead extraction is a complex procedure with potential complications.
  • Various lead types, insulation materials, and fixation methods exist, influencing extraction difficulty.

Purpose of the Study:

  • To evaluate the efficacy and safety of transvenous lead extraction in a large patient cohort.
  • To identify factors influencing procedural success and complications.
  • To assess the necessity of open-heart surgery for lead removal.

Main Methods:

  • A retrospective analysis of 228 chronic pacemaker lead extractions across 34 institutions.
  • Leads were accessed via implantation veins (subclavian, cephalic, jugular) or femoral approach.

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  • Data collected included patient demographics, lead characteristics, indications for extraction, procedural techniques, and complications.

    • Main Results:

    • Successful complete extraction was achieved in 194 out of 228 leads (85%).
    • Indications for extraction included infection (48%), prophylaxis/replacement (40%), and others (12%).
    • Serious procedural complications were rare (e.g., torn atrium, hemothorax, myocardial avulsion).

    Conclusions:

    • Intravascular lead extraction is a viable and beneficial technique for managing chronic pacemaker leads.
    • Adequate intensive training and availability of open-heart surgical backup are crucial for safe and effective procedures.
    • This technique can potentially obviate the need for open-heart surgery for lead extraction.