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Starfix lead extraction: Clinical experience and technical issues.

Pier Giorgio Golzio1, Ilaria Meynet1, Fulvio Orzan1

  • 1Division of Cardiology, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.

Journal of Cardiology Cases
|December 15, 2018
PubMed
Summary
This summary is machine-generated.

Transvenous lead extraction (TLE) of Starfix leads can be difficult, especially with distant tip placement. Modified delivery catheters and experienced operators are crucial for successful TLE when conventional methods fail.

Keywords:
Active-fixation leadsCoronary sinusInfectionLead extractionStarfix lead

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Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Transvenous lead extraction (TLE) of Starfix coronary sinus (CS) active-fixation leads presents unique challenges.
  • Complications include undeployed fixation lobes and venous occlusion, necessitating specialized techniques.

Purpose of the Study:

  • To report the experience with TLE of a Starfix lead in a challenging clinical scenario.
  • To compare outcomes with existing data on Starfix lead extraction.

Main Methods:

  • A case of TLE for Starfix lead due to infective endocarditis was performed.
  • Conventional methods failed; an off-label modification of the delivery catheter was employed.
  • A gooseneck snare was used to retrieve a fragmented lead tip.

Main Results:

  • The Starfix lead tip was in a distant, anterior position within the great cardiac vein.
  • Standard dilatation and delivery catheters were ineffective.
  • Modified delivery catheter and snare retrieval were ultimately successful despite lead fragmentation.

Conclusions:

  • TLE of Starfix leads is challenging, particularly with anteriorly located tips.
  • Modified delivery catheters can aid extraction when conventional tools fail.
  • Experienced operators employing non-conventional techniques are essential for managing complex Starfix TLE cases.