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Cardiac pacemaker electrodes: improved methods of extraction. Work in progress
C W Smith1, J C Messenger, S P Schaner
1Department of Radiology, Memorial Medical Center, Long Beach, CA.
Purpose:
To develop improved methods of extracting pacemaker electrodes from the femoral vein by using standard equipment and techniques.
Materials And Methods:
Pacemaker electrodes were removed from 61 patients aged 21-91 years (mean, 68 years). In 25 patients (41%), traction was applied to locking stylets to remove electrodes at the subclavian vein entry site. In 30 patients, the electrode tip was freed with traction at the subclavian vein entry site. The electrode was then extracted through a sheath placed in the femoral vein. In six patients (10%), the electrode tip was freed via the femoral vein when traction was applied to grasping devices. The electrode was then removed through a femoral venous sheath.
Results:
Ninety-nine (95%) of 104 pacemaker electrodes were extracted completely. Two electrodes were trapped in fibrous tissue in the subclavian vein. One right atrial tear occurred.
Conclusion:
Pacemaker electrodes can be removed effectively by using percutaneous techniques.