open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29
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The effectiveness of transvenous leads extractions implanted more than 10 years before

Aleksander Maciąg, Paweł Syska, Andrzej Przybylski, Krzysztof Kuśmierski, Maciej Sterliński, Artur Oręziak, Mariusz Pytkowski, Jacek Różański, Hanna Szwed
DOI: 10.5603/CJ.a2013.0143
·
Cardiol J 2014;21(4):419-424.

open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29

Abstract

Background: The increasing number of patients with cardiac implantable electronic devices (CIEDs) causes a rise in the absolute percentage of individuals qualifying for a transvenous lead extraction (TLE) due to infectious, vascular or lead failure related indications. As the survival time prolongs, TLE procedures more and more often concern the electrodes of long- -term functioning. Authors provide a retrospective analysis of the effectiveness and safety of TLE performed on leads implanted at least 10 years before the extraction.

Methods: Between 2008 and 2012 we performed TLE of 364 electrodes in 217 patients. Out of these, 66 (18.1%) leads in 43 (19.8%) patients had been implanted for at least 10 years. The mean dwelling time for electrodes was 161 months (120 to 330). In 62% of cases CIED-related infection was an indication for TLE. The following extracting techniques were used: manual direct traction, device traction, mechanical telescopic sheaths, autorotational cutting sheaths and femoral approach.

Results: Fifty-eight pacemakers and 8 defibrillating leads were extracted. Sixty-three (95%) completely, in the remaining 3 cases the clinical success was achieved with the small portion of the lead left into the vascular space. No major procedure complications were observed; minor complications were found in 3 (6%) patients.

Conclusions: TLE with the use of various endovascular techniques is an effective and safe method for treating infectious, vascular and mechanical complications of long-lasting CIEDs therapy.

Abstract

Background: The increasing number of patients with cardiac implantable electronic devices (CIEDs) causes a rise in the absolute percentage of individuals qualifying for a transvenous lead extraction (TLE) due to infectious, vascular or lead failure related indications. As the survival time prolongs, TLE procedures more and more often concern the electrodes of long- -term functioning. Authors provide a retrospective analysis of the effectiveness and safety of TLE performed on leads implanted at least 10 years before the extraction.

Methods: Between 2008 and 2012 we performed TLE of 364 electrodes in 217 patients. Out of these, 66 (18.1%) leads in 43 (19.8%) patients had been implanted for at least 10 years. The mean dwelling time for electrodes was 161 months (120 to 330). In 62% of cases CIED-related infection was an indication for TLE. The following extracting techniques were used: manual direct traction, device traction, mechanical telescopic sheaths, autorotational cutting sheaths and femoral approach.

Results: Fifty-eight pacemakers and 8 defibrillating leads were extracted. Sixty-three (95%) completely, in the remaining 3 cases the clinical success was achieved with the small portion of the lead left into the vascular space. No major procedure complications were observed; minor complications were found in 3 (6%) patients.

Conclusions: TLE with the use of various endovascular techniques is an effective and safe method for treating infectious, vascular and mechanical complications of long-lasting CIEDs therapy.

Get Citation

Keywords

lead extraction, pacing and defibrillation leads

About this article
Title

The effectiveness of transvenous leads extractions implanted more than 10 years before

Journal

Cardiology Journal

Issue

Vol 21, No 4 (2014)

Pages

419-424

Published online

2014-08-29

DOI

10.5603/CJ.a2013.0143

Bibliographic record

Cardiol J 2014;21(4):419-424.

Keywords

lead extraction
pacing and defibrillation leads

Authors

Aleksander Maciąg
Paweł Syska
Andrzej Przybylski
Krzysztof Kuśmierski
Maciej Sterliński
Artur Oręziak
Mariusz Pytkowski
Jacek Różański
Hanna Szwed

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