Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room
We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 tha...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2011-04, Vol.34 (2), p.345-351 |
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| creator | Kröpil, Patric Lanzman, Rotem S. Miese, Falk R. Blondin, Dirk Winter, Joachim Scherer, Axel Fürst, Günter |
| description | We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV;
n
= 3], superior vena cava [
n
= 2], brachiocephalic vein [
n
= 5], and subclavian vein [
n
= 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients. |
| doi_str_mv | 10.1007/s00270-010-9887-x |
| format | Article |
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n
= 3], superior vena cava [
n
= 2], brachiocephalic vein [
n
= 5], and subclavian vein [
n
= 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-010-9887-x</identifier><identifier>PMID: 20502898</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>ADMINISTRATIVE PROCEDURES ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty - methods ; BIOMEDICAL RADIOGRAPHY ; BLOOD VESSELS ; BODY ; Brachiocephalic Veins - diagnostic imaging ; CARDIAC PACEMAKERS ; Cardiology ; CARDIOVASCULAR SYSTEM ; Catheterization, Central Venous - methods ; Child ; Clinical Investigation ; Device Removal - instrumentation ; Device Removal - methods ; DIAGNOSTIC TECHNIQUES ; DOCUMENT TYPES ; ELEMENTS ; Equipment Failure ; EXTRACTION ; Female ; FEMALES ; Fluoroscopy ; Humans ; Imaging ; LEAD ; Male ; MALES ; MANUALS ; MEDICINE ; Medicine & Public Health ; METALS ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; NUCLEAR MEDICINE ; ORGANS ; Pacemaker, Artificial ; PATIENTS ; Postoperative Complications ; Radiography, Interventional - methods ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; Retrospective Studies ; SEPARATION PROCESSES ; Stents ; Subclavian Vein - diagnostic imaging ; Treatment Outcome ; Ultrasound ; VEINS ; Young Adult</subject><ispartof>Cardiovascular and interventional radiology, 2011-04, Vol.34 (2), p.345-351</ispartof><rights>Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010</rights><rights>Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-38913c47ddc733f1ffbfaa3f5db49431a2f815d109d6ae2bbf087e47950953183</citedby><cites>FETCH-LOGICAL-c398t-38913c47ddc733f1ffbfaa3f5db49431a2f815d109d6ae2bbf087e47950953183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-010-9887-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-010-9887-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,778,782,883,27913,27914,41477,42546,51308</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20502898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21608722$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Kröpil, Patric</creatorcontrib><creatorcontrib>Lanzman, Rotem S.</creatorcontrib><creatorcontrib>Miese, Falk R.</creatorcontrib><creatorcontrib>Blondin, Dirk</creatorcontrib><creatorcontrib>Winter, Joachim</creatorcontrib><creatorcontrib>Scherer, Axel</creatorcontrib><creatorcontrib>Fürst, Günter</creatorcontrib><title>Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV;
n
= 3], superior vena cava [
n
= 2], brachiocephalic vein [
n
= 5], and subclavian vein [
n
= 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.</description><subject>ADMINISTRATIVE PROCEDURES</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty - methods</subject><subject>BIOMEDICAL RADIOGRAPHY</subject><subject>BLOOD VESSELS</subject><subject>BODY</subject><subject>Brachiocephalic Veins - diagnostic imaging</subject><subject>CARDIAC PACEMAKERS</subject><subject>Cardiology</subject><subject>CARDIOVASCULAR SYSTEM</subject><subject>Catheterization, Central Venous - methods</subject><subject>Child</subject><subject>Clinical Investigation</subject><subject>Device Removal - instrumentation</subject><subject>Device Removal - methods</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DOCUMENT TYPES</subject><subject>ELEMENTS</subject><subject>Equipment Failure</subject><subject>EXTRACTION</subject><subject>Female</subject><subject>FEMALES</subject><subject>Fluoroscopy</subject><subject>Humans</subject><subject>Imaging</subject><subject>LEAD</subject><subject>Male</subject><subject>MALES</subject><subject>MANUALS</subject><subject>MEDICINE</subject><subject>Medicine & Public Health</subject><subject>METALS</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>NUCLEAR MEDICINE</subject><subject>ORGANS</subject><subject>Pacemaker, Artificial</subject><subject>PATIENTS</subject><subject>Postoperative Complications</subject><subject>Radiography, Interventional - methods</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Retrospective Studies</subject><subject>SEPARATION PROCESSES</subject><subject>Stents</subject><subject>Subclavian Vein - diagnostic imaging</subject><subject>Treatment Outcome</subject><subject>Ultrasound</subject><subject>VEINS</subject><subject>Young Adult</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10UFvFCEUB3BiNHatfgAvhujB0-gDhoU5Npuqm6xpYzTxRhhgWuoMrMA024PfXdapmph4Inn83iOPP0LPCbwhAOJtBqACGiDQdFKK5vAArUjLaANy_fUhWgERbUM4JyfoSc43AIRLyh-jEwocqOzkCv346IOf9Dje4W241dnfOrzR5doVl_BlisbZObmMS8RnOftc8CZO-9EbXZzFl9q4SX-rdOe0xeeHkrQpPgasg8XbCnUo-lfBB1yn4ou9S7UQrvCnGKen6NGgx-ye3Z-n6Mu788-bD83u4v12c7ZrDOtkaZjsCDOtsNYIxgYyDP2gNRu47duuZUTTQRJuCXR2rR3t-wGkcK3oOHScEclO0atlbszFq2x8cebaxBCcKYqSdeWUVvV6UfsUv88uFzX5bNxYl3Bxzkpy0Uq65lDly3_kTZxTqCscEREgW1YRWZBJMefkBrVP9avTnSKgjvmpJT9V81PH_NSh9ry4Hzz3k7N_On4HVgFdQK5X4cqlvy__f-pP40ymvw</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Kröpil, Patric</creator><creator>Lanzman, Rotem S.</creator><creator>Miese, Falk R.</creator><creator>Blondin, Dirk</creator><creator>Winter, Joachim</creator><creator>Scherer, Axel</creator><creator>Fürst, Günter</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20110401</creationdate><title>Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room</title><author>Kröpil, Patric ; Lanzman, Rotem S. ; Miese, Falk R. ; Blondin, Dirk ; Winter, Joachim ; Scherer, Axel ; Fürst, Günter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-38913c47ddc733f1ffbfaa3f5db49431a2f815d109d6ae2bbf087e47950953183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>ADMINISTRATIVE PROCEDURES</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty - methods</topic><topic>BIOMEDICAL RADIOGRAPHY</topic><topic>BLOOD VESSELS</topic><topic>BODY</topic><topic>Brachiocephalic Veins - diagnostic imaging</topic><topic>CARDIAC PACEMAKERS</topic><topic>Cardiology</topic><topic>CARDIOVASCULAR SYSTEM</topic><topic>Catheterization, Central Venous - methods</topic><topic>Child</topic><topic>Clinical Investigation</topic><topic>Device Removal - instrumentation</topic><topic>Device Removal - methods</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DOCUMENT TYPES</topic><topic>ELEMENTS</topic><topic>Equipment Failure</topic><topic>EXTRACTION</topic><topic>Female</topic><topic>FEMALES</topic><topic>Fluoroscopy</topic><topic>Humans</topic><topic>Imaging</topic><topic>LEAD</topic><topic>Male</topic><topic>MALES</topic><topic>MANUALS</topic><topic>MEDICINE</topic><topic>Medicine & Public Health</topic><topic>METALS</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>NUCLEAR MEDICINE</topic><topic>ORGANS</topic><topic>Pacemaker, Artificial</topic><topic>PATIENTS</topic><topic>Postoperative Complications</topic><topic>Radiography, Interventional - methods</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Retrospective Studies</topic><topic>SEPARATION PROCESSES</topic><topic>Stents</topic><topic>Subclavian Vein - diagnostic imaging</topic><topic>Treatment Outcome</topic><topic>Ultrasound</topic><topic>VEINS</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kröpil, Patric</creatorcontrib><creatorcontrib>Lanzman, Rotem S.</creatorcontrib><creatorcontrib>Miese, Falk R.</creatorcontrib><creatorcontrib>Blondin, Dirk</creatorcontrib><creatorcontrib>Winter, Joachim</creatorcontrib><creatorcontrib>Scherer, Axel</creatorcontrib><creatorcontrib>Fürst, Günter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kröpil, Patric</au><au>Lanzman, Rotem S.</au><au>Miese, Falk R.</au><au>Blondin, Dirk</au><au>Winter, Joachim</au><au>Scherer, Axel</au><au>Fürst, Günter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>34</volume><issue>2</issue><spage>345</spage><epage>351</epage><pages>345-351</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV;
n
= 3], superior vena cava [
n
= 2], brachiocephalic vein [
n
= 5], and subclavian vein [
n
= 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20502898</pmid><doi>10.1007/s00270-010-9887-x</doi><tpages>7</tpages></addata></record> |
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| ispartof | Cardiovascular and interventional radiology, 2011-04, Vol.34 (2), p.345-351 |
| issn | 0174-1551 1432-086X |
| language | eng |
| recordid | cdi_osti_scitechconnect_21608722 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | ADMINISTRATIVE PROCEDURES Adolescent Adult Aged Aged, 80 and over Angioplasty - methods BIOMEDICAL RADIOGRAPHY BLOOD VESSELS BODY Brachiocephalic Veins - diagnostic imaging CARDIAC PACEMAKERS Cardiology CARDIOVASCULAR SYSTEM Catheterization, Central Venous - methods Child Clinical Investigation Device Removal - instrumentation Device Removal - methods DIAGNOSTIC TECHNIQUES DOCUMENT TYPES ELEMENTS Equipment Failure EXTRACTION Female FEMALES Fluoroscopy Humans Imaging LEAD Male MALES MANUALS MEDICINE Medicine & Public Health METALS Middle Aged Minimally Invasive Surgical Procedures - methods NUCLEAR MEDICINE ORGANS Pacemaker, Artificial PATIENTS Postoperative Complications Radiography, Interventional - methods RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE Retrospective Studies SEPARATION PROCESSES Stents Subclavian Vein - diagnostic imaging Treatment Outcome Ultrasound VEINS Young Adult |
| title | Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room |
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