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Laser-assisted lead extraction: the European experience.

C Kennergren1, C A Bucknall, C Butter

  • 1Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. charles.kennergren@vgregion.se

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|June 29, 2007
PubMed
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Excimer laser-assisted lead extraction safely and effectively removes cardiac leads in Europe. This technique offers a predictable alternative to abandoning redundant leads, limiting open-heart procedures to complex cases.

Area of Science:

  • Cardiology
  • Medical Devices
  • Surgical Technology

Background:

  • Cardiac leads (pacing and implantable cardioverter-defibrillator) can become redundant or non-functional over time.
  • Abandoning leads in situ poses risks, including infection and interference.
  • Traditional lead extraction methods can be complex and carry significant risks.

Purpose of the Study:

  • To evaluate the safety and effectiveness of Excimer laser-assisted lead extraction across multiple European centers.
  • To present the comprehensive European multi-center study experience with this technology.

Main Methods:

  • A retrospective analysis of 383 lead extractions (170 atrial, 213 ventricular) in 292 patients across 14 European centers.
  • Utilized Excimer laser technology (308 nm wavelength) delivered via a flexible sheath to vaporize surrounding tissue and fibrosis.

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  • Data collected on patient demographics, lead implantation times, indications for extraction, procedure duration, success rates, and complications.

    • Main Results:

    • Complete lead extraction was achieved in 90.9% of cases, with partial extraction in 3.4%.
    • Extraction failure occurred in 5.7% of leads, with major complications (perforations) in 3.4%.
    • The overall complication rate was 5.1% (including 1.7% minor complications), with no in-hospital mortality.

    Conclusions:

    • Excimer laser-assisted lead extraction is a safe, effective, and predictable method for removing cardiac leads.
    • This technique can significantly reduce the need for open-heart surgery, reserving it for exceptional circumstances.
    • The findings suggest that abandoning redundant leads may no longer be the standard of care for many patients.