Extraction of old pacemaker or cardioverter-defibrillator leads by laser sheath versus femoral approach.
Pierre Bordachar,Pascal Defaye,Eric Peyrouse,Serge Boveda,Bilel Mokrani,Christelle Marquié,Laurent Barandon,Emilie Marcant Fossaert,Stéphane Garrigue,Sylvain Reuter,Julien Laborderie,Eloi Marijon,Jean-Claude Deharo,Peggy Jacon,Salem Kacet,Sylvain Ploux,Antoine Deplagne,Michel Haïssaguerre,Jacques Clémenty,Philippe Ritter,Didier Klug +20 more
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TLDR
Old transvenous leads were extracted with similar success and complication rates by the Femoral and laser approaches, however, the femoral approach was associated with longer procedures and a longer duration of fluoroscopic exposure.Abstract:
Background— Some operators routinely extract chronically implanted transvenous leads from a femoral, whereas others prefer a superior approach. This prospective study compared the safety and effectiveness of laser sheaths versus femoral snare extractions.
Methods and Results— The single-center study comprised 101 patients referred for unequivocal indications to extract ≥1 transvenous lead(s). Patients were >4 years of age and were randomly assigned to extractions with a laser sheath (group 1: n=50) versus a snare via femoral approach (group 2: n=51). The multicenter study comprised 358 patients who underwent extraction of old transvenous leads using laser sheaths (n=218, group 3) in 3 centers and from a femoral approach (n=138, group 4) in 3 other centers. In the single-center study, the success and complications rates were similar in groups 1 and 2. No patient died of a periprocedural complication. The procedural duration (51±22 versus 86±51 minutes) and duration of total fluoroscopic exposure (7±7 versus 21±17 minutes) were significantly shorter (each P <0.01) in group I than in group 2. In the multicenter study, we observed 2 procedure-associated deaths in group 3 versus 1 in group 4. Major procedural complications were observed in 3% of patients in group 3, versus 3% in group 4 ( P =NS). The rates of complete, partial, and unsuccessful extractions were similar in groups 3 and 4.
Conclusions— Old transvenous leads were extracted with similar success and complication rates by the femoral and laser approaches. However, the femoral approach was associated with longer procedures and a longer duration of fluoroscopic exposure.read more
Citations
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Esophageal capsule endoscopy after radiofrequency catheter ablation for atrial fibrillation: documented higher risk of luminal esophageal damage with general anesthesia as compared with conscious sedation.
Luigi Di Biase,Luigi Di Biase,Luis C. Saenz,David Burkhardt,Miguel Vacca,Claude S. Elayi,Conor D. Barrett,Rodney Horton,Rong Bai,Alan Siu,Tamer S. Fahmy,Dimpi Patel,Luciana Armaganijan,Chia Tung Wu,Sonne Kai,Ching Keong Ching,Karen P. Phillips,Robert A. Schweikert,Jennifer E. Cummings,Mauricio Arruda,Walid Saliba,Milan Dodig,Andrea Natale +22 more
TL;DR: The use of general anesthesia increases the risk of esophageal damage detected by capsule endoscopy, and this increased risk was statistically significant in patients undergoing general anesthesia or conscious sedation.
Journal ArticleDOI
Pathways for training and accreditation for transvenous lead extraction: a European Heart Rhythm Association position paper
Jean-Claude Deharo,Maria Grazia Bongiorni,A. Rozkovec,Frank A. Bracke,Pascal Defaye,I. Fernandez-Lozano,P. G. Golzio,Bert Hansky,Charles Kennergren,Antonis S. Manolis,P. Mitkowski,E. S. Platou,Charles J. Love,Bruce L. Wilkoff +13 more
TL;DR: The present document focuses on the rising burden and the increasing complexity of techniques of lead extraction with an emphasis on the critical issues of training, accreditation, and documentation of results.
Journal ArticleDOI
From lead management to implanted patient management: systematic review and meta-analysis of the last 15 years of experience in lead extraction
Igor Diemberger,Andrea Mazzotti,Mauro Biffi Giulia,Massaro Cristian,Martignani Matteo,Ziacchi Maria Letizia,Bacchi M L Reggiani,Paola Battistini,Giuseppe Boriani +8 more
TL;DR: A systematic review and meta-analysis of the last 15 years’ experience inercutaneous lead extraction gave an objective evaluation of the efficacy and safety of this procedure, and the main factors influencing these results were identified.
Journal ArticleDOI
Safety of transvenous lead extraction according to centre volume: a systematic review and meta-analysis
Antonio Di Monaco,Gemma Pelargonio,Maria Lucia Narducci,Lamberto Manzoli,Stefania Boccia,Maria Elena Flacco,Lorenzo Capasso,Lucy Barone,Francesco Perna,Gianluigi Bencardino,Teresa Rio,Milena Leo,Luigi Di Biase,Pasquale Santangeli,Pasquale Santangeli,Andrea Natale,A. G. Rebuzzi,Filippo Crea +17 more
TL;DR: Patients who have been treated in higher volume centres have a lower probability of minor complications and death at 30 days regardless of the infection rate, length of lead duration, type of device, and type of extraction, a meta-analysis of observational studies suggests.
Journal ArticleDOI
How adequate are the current methods of lead extraction? A review of the efficiency and safety of transvenous lead extraction methods
TL;DR: A stepwise extraction approach can result in a clinical successful TLE in up to 100% of the leads with a relatively low risk of procedure-related mortality and complications.
References
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Journal ArticleDOI
Transvenous Lead Extraction: Heart Rhythm Society Expert Consensus on Facilities, Training, Indications, and Patient Management: This document was endorsed by the American Heart Association (AHA)
Bruce L. Wilkoff,Charles J. Love,Charles L. Byrd,Maria Grazia Bongiorni,Roger G. Carrillo,George H. Crossley,Laurence M. Epstein,Richard A. Friedman,Richard A. Friedman,Charles Kennergren,Przemyslaw Mitkowski,Raymond Schaerf,Oussama M. Wazni +12 more
TL;DR: Cleveland Clinic, Department of Cardiovascular Medicine, Cleveland, OH, Ohio State University, Division of ardiovascular Medicine, Columbus, Ohio, Broward General Medical Center, Fort Lauderdale, FL, University Hospital, ivision of cardiovascular medicine, Pisa, Italy, University of Miami, Cardiothoracic Surgery, Miami, FL as discussed by the authors, St. Thomas esearch Institute and Providence St. Joseph Medical enter, Burbank, CA, American Heart Association Representative.
Journal ArticleDOI
Pacemaker lead extraction with the laser sheath: Results of the pacing lead extraction with the excimer sheath (PLEXES) trial
Bruce L. Wilkoff,Charles L. Byrd,Charles J. Love,David L. Hayes,T. Duncan Sellers,Raymond Schaerf,Victor Parsonnet,Laurence M. Epstein,Robert A. Sorrentino,Christopher Reiser +9 more
TL;DR: In this article, the safety and effectiveness of laser-assisted pacemaker lead extraction with the excimer sheath in comparison to non-laser lead extraction was evaluated in 301 patients with 465 chronically implanted pacemaker leads.
Journal ArticleDOI
Five-years experience with intravascular lead extraction. U.S. Lead Extraction Database.
TL;DR: With experienced operators, appropriate precautions, and appropriate patient selection, modern techniques allow the successful extraction of up to nearly 98% of intravascular leads with a relatively low incidence of complications.
Journal ArticleDOI
Transvenous removal of pacing and implantable cardiac defibrillating leads using single sheath mechanical dilatation and multiple venous approaches: high success rate and safety in more than 2000 leads
Maria Grazia Bongiorni,Ezio Soldati,Giulio Zucchelli,Andrea Di Cori,Luca Segreti,Raffaele De Lucia,Gianluca Solarino,Alberto Balbarini,Mario Marzilli,Mario Mariani +9 more
TL;DR: Mechanical single sheath extraction technique with multiple venous entry site approaches is effective, safe, and with a good cost effective profile for pacing and ICD leads removal.
Journal ArticleDOI
A single-centre experience of over one thousand lead extractions.
TL;DR: Laser-assisted lead extraction proved to be a useful technique to extract leads that could not be removed by manual traction, indicating that the paradigm of abandoning redundant leads, instead of removing them, may have to be reconsidered.
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