Incidence and Predictors of Successful Lead Extraction With Short Active Mechanical Extraction Sheaths Only
Caroline Wiederkehr1,2, Noah Kuster2, Michelle Bebié2
1Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland.
Journal of Cardiovascular Electrophysiology
|April 11, 2026
Summary
Short active mechanical extraction sheaths (SAMES) are sufficient for transvenous lead extraction (TLE) in nearly 10% of patients. Shorter lead dwell time and anticoagulation use predict successful TLE using only SAMES, with fewer complications.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Transvenous lead extraction (TLE) is a common procedure for cardiac implantable electronic device (CIED) issues.
- Active mechanical rotational sheaths aid TLE, with short (SAMES) and long versions available.
- The efficacy and patient selection for SAMES in TLE remain unclear.
Purpose of the Study:
- To determine the incidence of successful TLE using only SAMES.
- To identify predictors of successful TLE with SAMES.
- To evaluate complication rates associated with SAMES-only TLE.
Main Methods:
- Retrospective analysis of TLE procedures from 2013-2023.
- Inclusion of patients undergoing TLE with short or long active mechanical extraction sheaths.
- Assessment of clinical and radiological success, and complications.
Main Results:
- TLE was successful using only SAMES in 9.7% of 568 procedures.
- Shorter lead dwell time and anticoagulation were independent predictors of SAMES success.
- Lower complication rates were observed with SAMES-only TLE compared to longer sheaths.
Conclusions:
- SAMES are sufficient for successful TLE in approximately 10% of patients.
- SAMES may be a preferred primary tool for patients with shorter lead dwell times and on anticoagulation.
- Using SAMES as a primary tool could lead to reduced complication rates in selected TLE patients.
