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- Title
Usuwanie urwanych elektrod -- porównanie różnych dostępów i narzędzi.
- Authors
Kutarski, Andrzej; Jacheć, Wojciech; Pietura, Radosław; Stefańczyk, Paweł; Czajkowski, Marek; Sawonik, Sebastian; Tułecki, Łukasz; Nowosielecka, Dorota
- Abstract
INTRODUCTION Extraction of a broken lead fragment (BLF) has received scant attention in the literature. Our aim was to compare the effectiveness of different approaches and tools used for BLF removal during 127 procedures. RESULTS A superior approach was the most popular (75.59%), femoral (15.75%) and combined (8.66%) approaches were the least common. BLFs were removed in their entirety in 63.78% and BLF length was significantly reduced (to less than 4 cm) in 24.41%. The best results were achieved when BLFs were longer (>4 cm) (66.67%), either free-floating or in the pulmonary circulation (68.42%) but not in cases of short BLFs (20.0%). Complete procedural success was achieved in 70.87% of procedures, the lead tip retained in the heart wall and short BLFs were found in 25.98%, whereas BLFs >4 cm were left in place in 3.15% of procedures only. There was no relationship between approach in lead remnant removal and long-term mortality. CONCLUSIONS 1. Effectiveness of fractured lead removal is satisfactory: entire BLFs were removed in 51.97% and BLF length was significantly reduced in 27.56%. 2. Risk factors for lead fracture are implant duration (16.27 years on average), ventricular leads (71.65%), passive fixation leads (97.63%) and pacemaker leads (92.13%), but not ICD leads (only 7.87% of lead fractures). 3. Broken lead removal (superior approach) using a CS access sheath as a "subclavian workstation" for continuation of dilatation with conventional tools deserves attention. 4. Lead fracture management should become an integral part of training in transvenous lead extraction.
- Subjects
POLAND; COMPLICATIONS of prosthesis; FOREIGN bodies; MEDICAL device removal; ARTIFICIAL implants; TREATMENT effectiveness; CONFERENCES &; conventions; CARDIAC pacemakers; ELECTRODES
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, p33
- ISSN
0022-9032
- Publication type
Article