Transvenous Lead Extraction via the Inferior Approach Using a Gooseneck Snare versus Simple Manual Traction
Korean Circulation Journal
; : 186-196, 2016.
Article
en En
| WPRIM
| ID: wpr-221728
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND AND OBJECTIVES: The number of patients with cardiac implantable electronic devices needing lead extraction is increasing for various reasons, including infections, vascular obstruction, and lead failure. We report our experience with transvenous extraction of pacemaker and defibrillator leads via the inferior approach of using a gooseneck snare as a first-line therapy and compare extraction using a gooseneck snare with extraction using simple manual traction. SUBJECTS AND METHODS: The study included 23 consecutive patients (43 leads) who underwent transvenous lead extraction using a gooseneck snare (group A) and 10 consecutive patients (17 leads) who underwent lead extraction using simple manual traction (group B). Patient characteristics, indications, and outcomes were analyzed and compared between the groups. RESULTS: The dwelling time of the leads was longer in group A (median, 121) than in group B (median, 56; p=0.000). No differences were noted in the overall procedural success rate (69.6% vs. 70%), clinical procedural success rate (82.6% vs. 90%), and lead clinical success rate (86% vs. 94.1%) between the groups. The procedural success rates according to lead type were 89.2% and 100% for pacing leads and 66.7% and 83.3% for defibrillator leads in groups A and B, respectively. Major complications were noted in 3 (mortality in 1) patients in group A and 2 patients in group B. CONCLUSION: Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective. However, stand-alone transvenous extraction of defibrillator leads using the inferior approach was suboptimal.
Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Marcapaso Artificial
/
Tracción
/
Desfibriladores Implantables
/
Remoción de Dispositivos
/
Desfibriladores
/
Proteínas SNARE
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
En
Revista:
Korean Circulation Journal
Año:
2016
Tipo del documento:
Article