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Four-Stage Rocket technique: A novel strategy for lead extractions using laser sheaths from the femoral vein
Daisuke Kawano1, Kazuhisa Matsumoto1, Masataka Narita1
1Department of Cardiology, Saitama Medical University, International Medical Center, Hidaka, Japan.
Introduction:
Transvenous lead extractions (TLEs) for cardiac implantable electronic device complications often encounter difficulties with strong adhesions to the myocardium or vessels. In this report, we introduce a novel "Four-Stage Rocket" technique for effective TLE in cases where conventional methods fail.
Methods And Results:
Two challenging cases where conventional TLE methods failed were treated using a combination of four devices: Needle's Eye Snare, Agilis NxT Steerable Introducer, GlideLight Laser sheath, and GORE® DrySeal Flex Introducer sheath, employed via the inferior vena cava. The "Four-Stage Rocket" technique successfully detached firmly adhered leads near the tricuspid valve annulus, where the traditional superior vena cava approach was inadequate.
Conclusion:
The "Four-Stage Rocket" technique offers a potential alternative in complex TLE cases, aligning the laser direction with the adhesion detachment and reducing the tissue damage risk.
