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Related Experiment Videos

Chronic transvenous pacemaker lead removal using a unique, sequential transvenous system.

G K Brodell1, L W Castle, J D Maloney

  • 1Cleveland Clinic Foundation, Ohio 44195-5064.

The American Journal of Cardiology
|October 15, 1990
PubMed
Summary
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Transvenous removal of chronic pacemaker leads is effective using a locking stylet and sheaths. This method avoids thoracotomy, with complications like hemothorax and vein thrombosis being rare.

Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Chronic pacemaker leads often require removal due to device malfunction, infection, or patient need.
  • Lead extraction is crucial but can be challenging due to fibrous encapsulation and lead adherence.
  • Traditional methods may involve significant risks, necessitating advanced techniques.

Purpose of the Study:

  • To evaluate the efficacy and safety of a novel transvenous lead extraction technique.
  • To assess the utility of a unique locking stylet and sheaths in complex lead removal.
  • To document the success rates and complications associated with chronic pacemaker lead extraction.

Main Methods:

  • Transvenous extraction of 43 chronic pacemaker leads in 28 patients.

Related Experiment Videos

  • Utilized a unique locking stylet for traction without lead elongation.
  • Advanced sheaths over the lead to dilate and detach fibrous tissue.
  • Documented leads removed by traction, stylet alone, or stylet with sheaths.

    • Main Results:

    • Successful removal of 43 chronic pacemaker leads in 28 patients.
    • The locking stylet and sheaths were essential for explanting 32 leads.
    • 15 right atrial and 22 right ventricular leads were completely removed; 6 right ventricular leads subtotally removed.
    • Complications included myocardial avulsion (1), subacute hemothorax (1), subclavian vein thrombosis (1), and transient hypotension (1).

    Conclusions:

    • Chronic pacemaker leads can be reliably removed transvenously without thoracotomy.
    • A combination of a locking stylet and sheaths ensures consistent success in lead extraction.
    • The described technique offers a safe and effective approach to managing challenging lead removals.