Abstract
We report the case of a 50 year-old woman referred for extraction of an infected biventricular implantable cardioverter defibrillator (ICD) who underwent device and leads extraction. Due to adhesions at the level of the subclavian–innominate vein angle, manual traction with locking stylet was ineffective. A new mechanical sheath provided with a stainless steel bladed tip, the Evolution™ Mechanical Dilator Sheath (Cook Medical), was successfully used to complete lead extraction. As far as we know, this is the first report on the use of this new tool; its safety should be ascertained by increasing the number of cases but its simple use and its low cost make the Evolution™ Mechanical Dilator Sheath a new interesting tool that can be added to the instruments available for lead extraction.
References
Zipes, D. P., Camm, A. J., Borggrefe, M., et al. (2006). ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation, 114(10), e385–e484.
Vardas, P. E., Auricchio, A., & el al Blanc, J. J. (2007). ESC 2007 guidelines for cardiac pacing and cardiac resynchronization therapy. The task force for cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. Europace, 9, 959–998.
Rizzello, V., Dello Russo, A., Casella, M., & Biddau, R. (2008). Residual fibrous tissue floating in the right atrium after percutaneous pacemaker lead extraction: An unusual complication early detected by intracardiac echocardiography. International Journal of Cardiology, 127(2), e67–e68.
Kutalek, S. P. (2004). Pacemaker and defibrillator lead extraction. Current Opinion in Cardiology, 19, 19–22.
Love, C. J., Wilkoff, B. L., Byrd, C. L., 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 and Clinical Electrophysiology, 23(Part 1), 544–551.
Neuzil, P., Taborsky, M., Rezek, Z., et al. (2007). Pacemaker and ICD lead extraction with electrosurgical dissection sheaths and standard transvenous extraction systems: results of a randomized trial. Europace, 9(2), 98–104.
Byrd, C. L., Wilkoff, B. L., Love, C. J., et al. (2002). Clinical study of the laser sheath for lead extraction: the total experience in the United States. Pacing and Clinical Electrophysiology, 25, 804–808.
Kennergren, C., Bucknall, C. A., Butter, C., et al. (2007). Laser-assisted lead extraction: the European experience. Europace, 9(8), 651–656.
Acknowledgments
Special thanks to Mr Luciano Gabrielli, Astrid Bertoni and Massimo Terzi for their precious technical assistance.
Author information
Authors and Affiliations
Corresponding author
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
ESM
(AVI 37.0 MB)
Rights and permissions
About this article
Cite this article
Dello Russo, A., Biddau, R., Pelargonio, G. et al. Lead extraction: a new effective tool to overcome fibrous binding sites. J Interv Card Electrophysiol 24, 147–150 (2009). https://doi.org/10.1007/s10840-008-9326-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10840-008-9326-y