Transvenous Lead Extraction via the Inferior Approach Using a Gooseneck Snare versus Simple Manual Traction
Korean Circulation Journal 2016³â 46±Ç 2È£ p.186 ~ p.196
(Jo Uk) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
ȲÀ¯¹Ì(Hwang You-Mi) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
ÀÌÁöÇö(Lee Ji-Hyun) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
±è¹Î¼ö(Kim Min-Su) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
ÃÖÇü¿À(Choi Hyung-Oh) - Soonchunhyang University Hospital Department of Internal Medicine
ÀÌ¿ì¼®(Lee Woo-Seok) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
±ÇâÈñ(Kwon Chang-Hee) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
°í±â¿µ(Ko Gi-Young) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
À±Çö±â(Yoon Hyun-Ki) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
³²±âº´(Nam Gi-Byoung) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
ÃÖ±âÁØ(Choi Kee-Joon) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
±èÀ¯È£(Kim You-Ho) - University of Ulsan College of Medicine Asan Medical Center Heart Institute
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.
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Pacemaker, artificial, Defibrillators, implantable, Device removal
KMID :
0368120160460020186
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Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective.