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2014 ; 2014
(ä): 949785
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Percutaneous extraction of transvenous permanent pacemaker/defibrillator leads
#MMPMID24971363
Paraskevaidis S
; Konstantinou D
; Vassilikos V
; Theofilogiannakos E
; Mantziari L
; Megarisiotou A
; Galitsianos I
; Karvounis C
Biomed Res Int
2014[]; 2014
(ä): 949785
PMID24971363
show ga
BACKGROUND: Widespread use of cardiovascular implantable electronic devices has
inevitably increased the need for lead revision/replacement. We report our
experience in percutaneous extraction of transvenous permanent
pacemaker/defibrillator leads. METHODS: Thirty-six patients admitted to our
centre from September 2005 through October 2012 for percutaneous lead extraction
were included. Lead removal was attempted using Spectranetics traction-type
system (Spectranetics Corp., Colorado, CO, USA) and VascoExtor
countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany). RESULTS:
Lead extraction was attempted in 59 leads from 36 patients (27 men), mean ± SD
age 61 ± 5 years, with permanent pacemaker (n = 25), defibrillator (n = 8), or
cardiac resynchronisation therapy (n = 3) with a mean ± SD implant duration of 50
± 23 months. The indications for lead removal included pocket infection (n = 23),
endocarditis (n = 2), and ventricular (n = 10) and atrial lead dysfunction (n =
1). Traction device was used for 33 leads and countertraction device for 26
leads. Mean ± SD fluoroscopy time was 4 ± 2 minutes/lead for leads implanted <48
months (n = 38) and 7 ± 3 minutes/lead for leads implanted >48 months (n = 21), P
= 0.03. Complete procedural success rate was 91.7% and clinical procedural
success rate was 100%, while lead procedural success rate was 95%. CONCLUSIONS:
In conclusion, percutaneous extraction of transvenous permanent
pacemaker/defibrillator leads using dedicated removal tools is both feasible and
safe.