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A Novel Technique to Extract Implanted Leads Using Simple Stylets and Reused Rotational Sheaths in Patients with a
Serkan Çay1, Görkem Kuş2, Meryem Kara1
1Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yuksek Ihtisas Cardiovascular Building, Ankara City Hospital, Ankara, Türkiye.
Objective:
Transvenous lead extraction (TLE) is used in various clinical scenarios, such as device-related infections. Mechanically powered sheaths are one of the most commonly used tools for TLE procedures. We evaluated the procedural and clinical outcomes of a novel extraction technique for chronically implanted leads in the treatment of device-related infections.
Method:
The novel extraction technique utilizing standard implantation stylets, snares, reused rotational sheaths, catheters, and wires was evaluated for procedural success and clinical outcomes.
Results:
A total of 12 consecutive patients with device-related infections underwent the novel TLE procedure. Complete procedural success was achieved in all patients, with a minor complication rate of 8% (one patient). No major complications or procedure-related mortality were observed. During a median follow-up period of 435 days, one patient died due to a multidrug-resistant systemic infection, one due to end-stage heart failure, and one underwent valve surgery for concomitant valve endocarditis. No cases of reinfection were reported in the study population. Additionally, this novel technique was approximately 85% less costly than the conventional standard technique using locking stylets and unused rotational sheaths.
Conclusion:
In situations where unused extraction tools are unavailable or limited by reimbursement constraints, this novel TLE technique offers an effective and safe alternative.
