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Retained Wire Lead Extraction Techniques in Patients With Venous Occlusion.

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|April 3, 2026
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Summary

Retained wire techniques effectively restore venous access for cardiovascular implantable electronic device (CIED) procedures. The wire-in-lumen method showed the highest success rate in this study.

Keywords:
femoral tractionlead extractionretained wiresnaringvenous occlusion

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Venous occlusion from indwelling cardiovascular implantable electronic device (CIED) leads hinders lead revision or system upgrades.
  • Traditional methods for venous access restoration carry increased risks and complexity.
  • Retained wire techniques offer a practical alternative, but require further data.

Purpose of the Study:

  • To assess the feasibility, safety, and outcomes of four retained wire techniques combined with venoplasty.
  • To re-establish venous access in patients with complete venous occlusion undergoing CIED procedures.

Main Methods:

  • Retrospective analysis of patients undergoing transvenous lead extraction (TLE) for CIED revision or upgrade with complete venous occlusion.
  • Utilized retained wire techniques: wire-under-insulation (above/below), wire-in-lumen, and wire-through-coronary sinus lead.
  • Venoplasty was performed in conjunction with retained wire placement.

Main Results:

  • Successful venous access re-establishment in 98% (49/50) of patients who underwent a retained wire strategy.
  • The wire-in-lumen technique achieved a 97% success rate (35/36).
  • One case of pericardial effusion occurred, managed with pericardiocentesis.

Conclusions:

  • Retained wire techniques provide a safe and effective solution for venous occlusion during CIED procedures.
  • The wire-in-lumen technique is highly successful and broadly applicable.
  • These methods are particularly beneficial for mobile leads with modest dwell times.