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Percutaneous extraction of stented device leads.
Bryan Baranowski1, Oussama Wazni, Roy Chung
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA. baranob@ccf.org
Heart Rhythm
|December 21, 2011
Summary
Percutaneous extraction of device leads jailed by venous stents is feasible and safe. A combination of manual traction and a femoral approach achieved 100% lead removal without major complications.
Area of Science:
- Cardiovascular interventions
- Medical device retrieval
Background:
- Limited data exists on percutaneous extraction of device leads entrapped by venous stents.
- Venous stent placement can complicate future lead extraction procedures.
Observation:
- A retrospective review of 7 cases involving percutaneous extraction of chronically implanted device leads jailed by venous stents (left innominate/subclavian veins).
- Leads included both pacing and defibrillator types, with indwelling times up to 14 years.
Findings:
- Successful percutaneous extraction was achieved in all 7 cases (100%).
- Simple manual traction sufficed for 3 leads; the remaining 4 required a more complex femoral extraction approach.
- No major complications were reported during the extraction procedures.
Implications:
- Percutaneous extraction of stented device leads is a viable and safe strategy.
- A combination of manual traction and femoral access enables complete removal.
- This approach offers a solution for managing leads entrapped by venous stents, improving patient outcomes.
