Use of the mechanical dilator sheath for removal of endocardial leads: a single center experience

Pacing and Clinical Electrophysiology : PACE
Tolga AksuHalil Kisacik

Abstract

Due to an increasing number of cardiac device implantations, the number of leads that need to be extracted because of infection or lead failure is consistently rising. We present our experience in percutaneous lead removal in a single tertiary center. From December 2009 to August 2010, 12 patients underwent percutaneous lead extraction procedure by the Evolution™ mechanical dilator sheath (Cook Medical Inc., Bloomington, IN, USA) system after failure of manual traction and a locking stylet. Ages of the patients ranged between 7 and 86 years (mean age was 58 ± 12 years). Mean implantation time was 73 months (range between 12 and 244 months). Ten patients had one lead; only two patients had two leads. Indications for lead removal were: lead endocarditis in five patients, local (pocket) infection in four patients, and lead failure in three patients. All leads were successfully removed by using the device, except one lead which was one of the two leads in a patient with dual chamber pacemaker implanted 10 years ago. In three patients, same venous accesses (sheath of extraction system) were used to implant a new lead after removal of damaged leads without a new venous puncture. In only one patient, significant hematoma was found aft...Continue Reading

References

Nov 1, 1994·Pacing and Clinical Electrophysiology : PACE·H J SmithT D Sellers
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Citations

Jun 27, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Antonio Di MonacoFilippo Crea
Jan 24, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Tolga AksuTümer Erdem Güler
Mar 25, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Umit GurayBurcu Demirkan

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