Abstract
Transvenous lead removal is a complex technique. Many conditions play a role in lead extraction procedures and may affect technique, approaches, and results. In each case, lead design, lead damage, and patient anatomy may be significantly different, regardless of the removal technique. The description of any technique for transvenous lead extraction is always theoretical, exemplifying the most common situation; it must be emphasized that it is impossible to analyze and elucidate all possible conditions present in clinical practice [1]–[3]. The operator must plan the extraction procedure, and during the actual procedure, tailor techniques and tools to the individual circumstances in order to succeed and avoid complications [4], [5]. The fact that each case will have different conditions increases the importance of the extractor’s experience. Nevertheless, the number of different factors affecting the procedure may outweigh the operator’s experience, thus demanding that the operator develop an individual solution for each case.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Byrd CL, Schwartz SJ, Hedin NB (1991) Intravascular techniques for extraction of permanent pacemakers leads. J Thoracic Cardiovasc Surg 101:989–997
Bongiorni MG, Soldati E, Zucchelli G et al (2008) Transvenous removal of pacing and defibrillating leads using single sheath mechanical dilatation and multiple venous approaches: high success rate and safety in more than 2000 leads. Eur Heart J 29(23) 2886–2893
Love CJ (2007) Lead extraction. Heart Rhythm 4(9):1238–1243
Smith MC, Love CJ (2008) Extraction of transvenous pacing and ICD leads. Pacing Clin Electrophysiol 31(6):736–752
Love CJ, Wilkoff BL, Byrd CL et al (2000) Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads: indications, facilities, training. North American Society of Pacing and Electrophysiology Lead Extraction Conference Faculty. Pacing Clin Electrophysiol 23(4 Pt. 1):544–551
Magney JE, Flynn DM, Parsons JA et al (1993) Anatomical mechanisms explaining damage to pacemaker leads, defibrillator leads, and failure of central venous catheters adjacent to the sternoclavicular joint. Pacing Clin Electrophysiol 16:445–457
Bongiorni MG, Giannola G, Soldati E et al (2005) Pacing and implantable cardioverter-defibrillator transvenous lead extraction. Ital Heart J 6:261–266
Jarwe M, Klug D, Beregi JP et al (1999) Single center experience with femoral extraction of permanent endocardial pacing. Pacing Clin Electrophysiol 22:1202–1209
Klug D, Jarwe M, Messaoudène SA et al (2002) Pacemaker lead extraction with the needle’s eye snare for countertraction via a femoral approach. Pacing Clin Electrophysiol 25:1023–1028
Belott PH (2007) Lead extraction using the femoral vein. Heart Rhythm 4(8):1102–1107
De Martino G, Orazi S, Bisignani G et al (2005) Safety and feasibility of coronary sinus left ventricular pacing lead extraction: a preliminary report. J Interv Card Electrophysiol 13(1):35–38
Kasravi B, Tobias S, Barnes M, Messenger J (2005) Coronary sinus leads extraction in the era of cardiac resynchronization therapy: single centre experience. Pacing Clin Electrophysiol 28(1):51–53
Tyers GF, Clark J, Wang Y et al (2003) Coronary sinus lead extraction. Pacing Clin Electrophysiol. 26(1 Pt. 2):524–526
Bongiorni MG, Zucchelli G, Soldati E et al (2007) Usefulness of mechanical transvenous dilatation and location of areas of adherence in patients undergoing coronary sinus lead extraction. Europace 9:69–73
Bongiorni MG, Di Cori A, Zucchelli G et al (2010) A modified transvenous single mechanical dilatation technique to remove a chronically implanted active-fixation coronary sinus pacing lead. Pacing Clin Electrophysiol [Epub ahead of print]
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Italia
About this chapter
Cite this chapter
Bongiorni, M.G., Soldati, E. (2011). Problem-Solving in Lead Extraction. In: Bongiorni, M.G. (eds) Transvenous Lead Extraction. Springer, Milano. https://doi.org/10.1007/978-88-470-1466-4_10
Download citation
DOI: https://doi.org/10.1007/978-88-470-1466-4_10
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-1465-7
Online ISBN: 978-88-470-1466-4
eBook Packages: MedicineMedicine (R0)