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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
Summary
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.
- 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.
