Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series

Transvenous lead extraction (TLE) is regarded as the first-line strategy for the management of complications associated with cardiac implantable electronic devices (CIEDs), when lead removal is mandatory. The decision to perform a lead extraction should take into consideration not only the strength of the clinical indication for the procedure but also many other factors such as risks versus benefits, extractor and team experience, and even patient preference. TLE is a procedure with a possible high risk of complications. In this paper, we present three clinical cases of patients who presented different indications of TLE and explain how the procedures were successfully performed. In the first clinical case, TLE was necessary because of device extravasation and suspicion of CIED pocket infection. In the second clinical case, TLE was necessary because occlusion of the left subclavian vein was found when an upgrade to cardiac resynchronization therapy was performed. In the last clinical case, TLE was necessary in order to remove magnetic resonance (MR) non-conditional leads, so the patient could undergo an MRI examination for the management of a brain tumor.

[1]  A. Kutarski,et al.  Transvenous Lead Extraction in Adult Patient with Leads Implanted in Childhood-Is That the Same Procedure as in Other Adult Patients? , 2022, International journal of environmental research and public health.

[2]  Paul-Mihai Boarescu,et al.  Transvenous Lead Extraction Procedure—Indications, Methods, and Complications , 2022, Biomedicines.

[3]  C. Israel,et al.  [2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)]. , 2022, Giornale italiano di cardiologia.

[4]  Y. On,et al.  Transvenous lead extraction using the TightRail mechanical rotating dilator sheath for Asian patients , 2021, Scientific reports.

[5]  A. Kutarski,et al.  A Study of Major and Minor Complications of 1500 Transvenous Lead Extraction Procedures Performed with Optimal Safety at Two High-Volume Referral Centers , 2021, International journal of environmental research and public health.

[6]  A. Kutarski,et al.  The Influence of Lead-Related Venous Obstruction on the Complexity and Outcomes of Transvenous Lead Extraction , 2021, International journal of environmental research and public health.

[7]  A. Kutarski,et al.  Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage , 2021, International journal of environmental research and public health.

[8]  A. Kutarski,et al.  Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience , 2021, Vascular health and risk management.

[9]  A. Kutarski,et al.  Prognostic Value of Preoperative Echocardiographic Findings in Patients Undergoing Transvenous Lead Extraction , 2021, International journal of environmental research and public health.

[10]  D. Szczesniak-Stanczyk,et al.  Transesophageal Echocardiography as a Monitoring Tool during Transvenous Lead Extraction—Does It Improve Procedure Effectiveness? , 2020, Journal of clinical medicine.

[11]  Matthew Albert,et al.  Tips and Tricks , 2020, Clinics in Colon and Rectal Surgery.

[12]  G. Mascioli,et al.  Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience , 2020, Journal of arrhythmia.

[13]  A. Kutarski,et al.  Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools , 2020, Journal of clinical medicine.

[14]  O. Ozeke,et al.  Comparison of two types of rotational mechanical dilatator sheath: Evolution® and TightRail™ , 2019, Pacing and clinical electrophysiology : PACE.

[15]  R. Carrillo,et al.  Transvenous Lead Extractions: Current Approaches and Future Trends. , 2018, Arrhythmia & electrophysiology review.

[16]  P. Della Bella,et al.  Safety and efficacy of the new bidirectional rotational Evolution® mechanical lead extraction sheath: results from a multicentre Italian registry , 2018, 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.

[17]  N. Parakh,et al.  Safety of magnetic resonance imaging in patients with cardiac devices , 2018 .

[18]  N. Grabow,et al.  Neointimal fibrotic lead encapsulation - Clinical challenges and demands for implantable cardiac electronic devices. , 2017, Journal of cardiology.

[19]  G. Kumar,et al.  Cardiac implantable electronic device infections: Who is at greatest risk? , 2017, Heart rhythm.

[20]  R. Steckiewicz,et al.  Morphometric parameters of cardiac implantable electronic device (CIED) pocket walls observed on device replacement. , 2017, Folia morphologica.

[21]  L. Epstein,et al.  Strategies for Transvenous Lead Extraction Procedures , 2017, The Journal of innovations in cardiac rhythm management.

[22]  V. Ribeiro,et al.  Lead Extraction of Cardiac Rhythm Devices: A Report of a Single-Center Experience , 2017, Frontiers in cardiovascular medicine.

[23]  Jason C. Rubenstein,et al.  Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator , 2017, New England Journal of Medicine.

[24]  K. Aytemir,et al.  Initial experience with the TightRail™ Rotating Mechanical Dilator Sheath for transvenous lead extraction. , 2016, 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.

[25]  Gautham Kalahasty,et al.  Implantable Cardiac Defibrillator Lead Failure and Management. , 2016, Journal of the American College of Cardiology.

[26]  Ji-hong Guo,et al.  Prevalence of venous occlusion in patients referred for lead extraction: implications for tool selection. , 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.

[27]  A. Róka,et al.  Current Issues and Recent Advances in Pacemaker Therapy , 2012 .

[28]  S. Metaxa,et al.  Intravascular Lead Extractions: Tips and Tricks , 2012 .

[29]  M. Grabowski,et al.  Differences in encapsulating lead tissue in patients who underwent transvenous lead removal. , 2012, 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.

[30]  Samuel O Jones,et al.  Long-Term Mortality After Transvenous Lead Extraction , 2012, Circulation. Arrhythmia and electrophysiology.

[31]  Patrick M Colletti,et al.  Magnetic resonance imaging in patients with cardiac pacemakers: era of "MR Conditional" designs , 2011, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[32]  Michel Haïssaguerre,et al.  Long‐Term Outcomes after Pocket or Scar Revision and Reimplantation of Pacemakers with Preerosion , 2011, Pacing and clinical electrophysiology : PACE.

[33]  David O. Martin,et al.  Initial experience with the Evolution mechanical dilator sheath for lead extraction: safety and efficacy. , 2010, Heart rhythm.

[34]  K. Ellenbogen,et al.  ICD Lead Design and the Management of Patients with Lead Failure. , 2009, Cardiac electrophysiology clinics.

[35]  F. Bracke,et al.  Venous Occlusion of the Access Vein in Patients Referred for Lead Extraction: , 2003, Pacing and clinical electrophysiology : PACE.

[36]  T. D. Sellers,et al.  Five‐Years Experience with Intravascular Lead Extraction , 1994 .