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Cardiac Lead Extraction with a Novel Locking Stylet

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Extraction of chronically implanted pacing and defibrillator leads is facilitated by using specialized locking stylets placed in the lead to allow application of traction and to stabilize the lead during sheath dissection of fibrotic tissue. We report the initial multicenter series of cases using a novel lead locking device (LLD). In 57 consecutive patients presenting at 6 institutions for lead extraction, 99 leads were treated using the LLD. After removing the pulse generator, leads were severed, the inner coil dilated and an LLD was successfully inserted and locked in the inner lumen of 95/99 (96±%) leads. With traction applied to the LLD, a variety of sheaths were advanced over the lead body to separate it from adhesions. In 97/99 (98±%) leads, all or most of the lead was removed via the implant vein; 2 leads were removed via the femoral vein. No major complications were observed. The LLD deploys safely and reliably, and provides stable support for advancement of dissecting sheaths.

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References

  1. Byrd CL, Schwartz SJ, Fearnot N, et al. Intravascular lead extraction using locking stylets and sheaths. PACE 1990;13:1871-1875.

    Google Scholar 

  2. Wilkoff BL. Intravascular lead extractions: details and keys to success. In: Singer I, (ed.), Interventional Electrophysiology. Williams and Wilkins Medical Publishers, Baltimore, 1997:1055-1084.

    Google Scholar 

  3. Wilkoff BL, Al-Khadra AS. The technique of transvenous lead extraction. In: Sanger I, Barold SS, Camm AJ, (eds.), Nonpharmacological therapy of arrhythmias for the 21st century: the state of the art. Futura Publishing Co, Inc, Armonk, NY, 1998:745-773.

    Google Scholar 

  4. Smith HJ, Fearnot NE, Byrd CL, et al. Five-years experience with intravascular lead extraction. PACE 1994;17(Part II):2016-2020.

    Google Scholar 

  5. Wilkoff BL, Byrd CL, Love CJ, et al. Pacemaker lead extraction with the laser sheath: results of the Pacing Lead Extraction with the Excimer Sheath (PLEXES) trial. J Am Coll Cardiol 1999;33:1671-1676.

    Google Scholar 

  6. Epstein LM, Byrd CL, Wilkoff BL, et al. Initial experience with larger laser sheaths for the removal of transvenous pacemaker and implantable defibrillator leads. Circulation 1999;100:516-525.

    Google Scholar 

  7. Kennergren C. Excimer laser extraction of permanent pacemaker and ICD leads: present experiences of a European multi-centre study. Eu J Cardio-Thoracic Surg 1999;15:856-860.

    Google Scholar 

  8. Fearnot NE, Smith HJ, Goode LB, et al. Intravascular lead extraction using locking stylets, sheaths, and other techniques. PACE 1990;13:1864-1870.

    Google Scholar 

  9. Alt E, Neuzner J, Binner L, et al. Three-year experience with a stylet for lead extraction: a multicenter study. PACE 1996;19:18-25.

    Google Scholar 

  10. Sellers TD, Coe S, Coates CW, Reiser C. New Tools for Extraction of Pacemaker and Defibrillator Leads: Advancement in Stylet Technology. Cardiovascular Reviews & Reports 2000;21:549-553.

    Google Scholar 

  11. Wolfe MW, Roubin GS, Schweiger M, et al. Length of hospital stay and complications after percutaneous transluminal coronary angioplasty: clinical and procedural predictors. Circulation 1995;92:311-319.

    Google Scholar 

  12. Byrd C, Schwartz S, Hedin N. Lead extraction indications and techniques. Cardiol Clinics 1992;10:735-748.

    Google Scholar 

Download references

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Authors and Affiliations

  1. Sahlgrenska University Hospital, Gothenberg, Sweden

    Charles Kennergren

  2. St. Joseph's Medical Center, Burbank, CA, USA

    Raymond H.M. Schaerf

  3. Memorial Hospital, Colorado Springs, CO, USA

    T. Duncan Sellers

  4. The Cleveland Clinical Foundation, Cleveland, OH, USA

    Bruce L. Wilkoff

  5. Broward General Medical Center, Ft. Lauderdale, FL, USA

    Charles L. Byrd

  6. Vancouver General Hospital, Vancouver, BC, Canada

    G. Frank O. Tyres

  7. Spectranetics, Colorado Springs, CO, USA

    Sean Coe, Charles W. Coates & Christopher Reiser

Authors
  1. Charles Kennergren
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  2. Raymond H.M. Schaerf
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  3. T. Duncan Sellers
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  4. Bruce L. Wilkoff
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  5. Charles L. Byrd
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  6. G. Frank O. Tyres
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  7. Sean Coe
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  8. Charles W. Coates
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  9. Christopher Reiser
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Kennergren, C., Schaerf, R.H., Sellers, T.D. et al. Cardiac Lead Extraction with a Novel Locking Stylet. J Interv Card Electrophysiol 4, 591–593 (2000). https://doi.org/10.1023/A:1026561414148

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  • DOI: https://doi.org/10.1023/A:1026561414148

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