Abstract
Technological advances in transvenous lead removal can be achieved by improving the materials and tools for lead extraction or modifying the techniques and approaches. I started the activity of transvenous lead removal in S. Chiara Hospital in Pisa, Italy, in December 1989; since then, with my coworkers, we have managed more than 2,500 pacing and implantable cardioverter-defibrillator (ICD) leads [1]. From the beginning, the technique and approaches have been continuously changed and improved, and by the beginning of 1997, we considered technique maturation to be complete [2]. From 1994 to 1996, we experienced the internal jugular approach to remove free-floating leads, and at the beginning of 1997, we started using it also in case of standard technique failure [3]. The first techniques I learned and applied for lead removal were traction with locking stylet, counter-pressure, and countertraction, as described by Byrd et al. [4], using polypropylene sheaths. Very often, we experienced the inability to insert the stylet up to the lead tip because of lead damage or stylet unlocking during traction; moreover, the force necessary to apply counterpressure and countertraction was discouraging.
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References
Bongiorni MG, Soldati E, Zucchelli G et al (2010) Transvenous removal of pacing and defibrillating leads: 13 years of experience in a single center. Heart Rhythm 7(Suppl 5) pp 36–42
Bongiorni MG, Soldati E, Grana M et al (1997) The internal transjugular approach: a new technique for transvenous lead removal. Proceedings of Third International Symposium on Pacing Leads Sept 11–13, 1997, Vol 1. Monduzzi Editore, Italy, pp 487–490
Bongiorni MG, Soldati E, Gherarducci G et al (2002) Percutaneous extraction of infected pacemaker/ICD leads: what are the current technological advances and result? In: Raviele A, ed. Cardiac arrhythmias 2001, Springer-Verlag Italia, Milan pp 623–630
Byrd CL, Schwartz SJ, Hedin NB et al (1990) Intravascular lead extraction using locking stylets and sheaths. Pacing Clin Electrophysiol 13:1871–1875
Wilkoff BL, Love CJ, Byrd CL et al (2009) Transvenous lead extraction: Heart Rhythm Society Expert Consensus on Facilities, Training, Indications, and Patient Management. Heart Rhythm 6(7):1085–1104
Eckhard A, Neuzner J, Binner L (1996) Three year experience with a stylet for lead extraction: a multicenter study. Pacing Clin Electrophysiol 19(1)18–25
De Martino G, Orazi S, Bisignani G et al (2005) Safety and feasibility of coronary sinus left ventricular pacing leads extraction: a preliminary report. J Interv Card Electrophysiol 13(1):35–38
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
Kennergren C (2008) European perspective on lead extraction. Part II. Heart Rhythm 5(2):320–323
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© 2011 Springer-Verlag Italia
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Bongiorni, M.G. (2011). Personal Technique and Experience: The Pisa Approach. In: Bongiorni, M.G. (eds) Transvenous Lead Extraction. Springer, Milano. https://doi.org/10.1007/978-88-470-1466-4_5
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DOI: https://doi.org/10.1007/978-88-470-1466-4_5
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