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Extraction: Advanced Methods00:56

Extraction: Advanced Methods

Metal ions can be separated from one another by complexation with organic ligands–the chelating agent– to form uncharged chelates. Here, the chelating agent must contain hydrophobic groups and behave as a weak acid, losing a proton to bind with the metal. Since most organic ligands used in this process are insoluble or undergo oxidation in the aqueous phase, the chelating agent is initially added to the organic phase and extracted into the aqueous phase. The metal-ligand complex is formed in...

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Advanced techniques for chronic lead extraction: heading from the laser towards the evolution system.

Patrizio Mazzone1, Dimitris Tsiachris, Alessandra Marzi

  • 1Arrhythmia Unit and Electrophysiology Laboratories, Department of Cardiology and Cardiothoracic Surgery, Ospedale San Raffaele, via Olgettina 60, Milan, Italy.

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
|May 7, 2013
PubMed
Summary

The Evolution system offers safe and effective chronic lead extraction (LE), comparable to the laser system. While requiring more snare use, it demonstrates similar success and complication rates in lead removal procedures.

Keywords:
Lead extractionPowered sheathSnare

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Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Chronic lead extraction (LE) is crucial for managing cardiac implantable electronic devices.
  • Mechanical dilator sheaths have improved LE outcomes.
  • The Evolution system is a newer alternative to traditional laser sheaths for powered LE.

Purpose of the Study:

  • To compare the safety and efficacy of the Evolution system versus the excimer laser system for chronic lead extraction.
  • To evaluate procedural success and complication rates between the two systems.

Main Methods:

  • Retrospective analysis of lead extraction procedures performed between 2005 and 2014.
  • Comparison of outcomes between patients treated with the excimer laser system (n=73) and the Evolution system (n=48).
  • Data collected on procedural success, clinical success, complication rates, and use of adjunctive devices.

Main Results:

  • Patients in the Evolution group had more leads extracted per patient and longer implant durations.
  • Complete procedural success was high in both groups (91.7% Evolution vs. 97.3% laser).
  • Clinical success (97.9% Evolution vs. 98.6% laser) and complication rates were similar between groups, though snare use was higher with the Evolution system.

Conclusions:

  • The Evolution system provides a safe and effective alternative for chronic lead extraction.
  • While requiring increased use of snares, the Evolution system achieves comparable procedural and clinical success rates to the laser system.
  • The Evolution system demonstrates acceptable safety and efficacy for lead extraction procedures.