The use of laser lead extraction sheath in the presence of supra-cardiac occlusion of the central veins for cardiac implantable electronic device lead upgrade or revision
The implantation of cardiac implantable electronic devices (CIED) has increased in the last decades with improvement in the quality of life of patients with cardiac rhythm disorders. The presence of bilateral subclavian, innominate or superior vena cava obstruction is a major limitation to device re...
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| creator | Al-Maisary, Sameer Romano, Gabriele Karck, Matthias De Simone, Raffaele Kremer, Jamila |
| description | The implantation of cardiac implantable electronic devices (CIED) has increased in the last decades with improvement in the quality of life of patients with cardiac rhythm disorders. The presence of bilateral subclavian, innominate or superior vena cava obstruction is a major limitation to device revision and/or upgrade.
This is retrospective study of patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Spectranetics Corporation, Colorado Springs, USA) with lead revision or upgrade using the laser sheath as a guide rail. Patients with known occlusion, severe stenosis or functional obstruction of the venous access vessels with indwelling leads were included in this study.
106 patients underwent percutaneous LLE with lead revision and/or upgrade. Preoperative known complete occlusion or severe stenosis of access veins was present in 23 patients (21.5%). More patients with implantable cardioverter-defibrillator (ICD) underwent LLE (64.1%) than patients with CRT-Ds (24.5%) and pacemaker patients (11.3%). In total 172 leads were extracted: 79 (45.9%) single-coil defibrillator leads, 35 (20.3%) dual-coil defibrillator leads, 31 (18.0%) right atrial leads, 24 (13.9%) right ventricular leads and three (1.7%) malfunctional coronary sinus left ventricular pacing leads. The mean age of leads was 99.2±65.6 months. The implantation of new leads after crossing the venous stenosis/obstruction was successful in 98 (92.4%) cases. Postoperative complications were pocket hematoma in two cases and wound infection in one case. No peri-operative and no immediate postoperative death was recorded. One intraoperative superior vena cava tear was treated by immediate thoracotomy and surgical repair.
In a single-center study on LLE in the presence of supra-cardiac occlusion of the central veins for CIED lead upgrade and revision we could demonstrate a low procedural complication rate with no procedural deaths. Most of the leads could be completely extracted to revise or upgrade the system. Our study showed a low complication rate, with acceptable mortality rates. |
| doi_str_mv | 10.1371/journal.pone.0251829 |
| format | Article |
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This is retrospective study of patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Spectranetics Corporation, Colorado Springs, USA) with lead revision or upgrade using the laser sheath as a guide rail. Patients with known occlusion, severe stenosis or functional obstruction of the venous access vessels with indwelling leads were included in this study.
106 patients underwent percutaneous LLE with lead revision and/or upgrade. Preoperative known complete occlusion or severe stenosis of access veins was present in 23 patients (21.5%). More patients with implantable cardioverter-defibrillator (ICD) underwent LLE (64.1%) than patients with CRT-Ds (24.5%) and pacemaker patients (11.3%). In total 172 leads were extracted: 79 (45.9%) single-coil defibrillator leads, 35 (20.3%) dual-coil defibrillator leads, 31 (18.0%) right atrial leads, 24 (13.9%) right ventricular leads and three (1.7%) malfunctional coronary sinus left ventricular pacing leads. The mean age of leads was 99.2±65.6 months. The implantation of new leads after crossing the venous stenosis/obstruction was successful in 98 (92.4%) cases. Postoperative complications were pocket hematoma in two cases and wound infection in one case. No peri-operative and no immediate postoperative death was recorded. One intraoperative superior vena cava tear was treated by immediate thoracotomy and surgical repair.
In a single-center study on LLE in the presence of supra-cardiac occlusion of the central veins for CIED lead upgrade and revision we could demonstrate a low procedural complication rate with no procedural deaths. Most of the leads could be completely extracted to revise or upgrade the system. Our study showed a low complication rate, with acceptable mortality rates.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0251829</identifier><identifier>PMID: 33989335</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Cardiac patients ; Care and treatment ; Complications ; Complications and side effects ; Demography ; Drafting software ; Electronic equipment ; Engineering and Technology ; Guide rails ; Heart ; Heart surgery ; Implants, Artificial ; Lasers ; Lead ; Medicine and Health Sciences ; Mortality ; Occlusion ; Patient outcomes ; Patients ; Prosthesis ; Quality of life ; Revisions ; Sheaths ; Success ; Surgery ; Transplants & implants ; Veins & arteries ; Venous access ; Wire</subject><ispartof>PloS one, 2021-05, Vol.16 (5), p.e0251829-e0251829</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Al-Maisary et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Al-Maisary et al 2021 Al-Maisary et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-2aed8e0d3bc84bc67b61ea45a701433ba4d87605f14f7720be8d1dd66a183f263</citedby><cites>FETCH-LOGICAL-c692t-2aed8e0d3bc84bc67b61ea45a701433ba4d87605f14f7720be8d1dd66a183f263</cites><orcidid>0000-0001-8758-1722</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121537/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121537/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33989335$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Coppola, Giuseppe</contributor><creatorcontrib>Al-Maisary, Sameer</creatorcontrib><creatorcontrib>Romano, Gabriele</creatorcontrib><creatorcontrib>Karck, Matthias</creatorcontrib><creatorcontrib>De Simone, Raffaele</creatorcontrib><creatorcontrib>Kremer, Jamila</creatorcontrib><title>The use of laser lead extraction sheath in the presence of supra-cardiac occlusion of the central veins for cardiac implantable electronic device lead upgrade or revision</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The implantation of cardiac implantable electronic devices (CIED) has increased in the last decades with improvement in the quality of life of patients with cardiac rhythm disorders. The presence of bilateral subclavian, innominate or superior vena cava obstruction is a major limitation to device revision and/or upgrade.
This is retrospective study of patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Spectranetics Corporation, Colorado Springs, USA) with lead revision or upgrade using the laser sheath as a guide rail. Patients with known occlusion, severe stenosis or functional obstruction of the venous access vessels with indwelling leads were included in this study.
106 patients underwent percutaneous LLE with lead revision and/or upgrade. Preoperative known complete occlusion or severe stenosis of access veins was present in 23 patients (21.5%). More patients with implantable cardioverter-defibrillator (ICD) underwent LLE (64.1%) than patients with CRT-Ds (24.5%) and pacemaker patients (11.3%). In total 172 leads were extracted: 79 (45.9%) single-coil defibrillator leads, 35 (20.3%) dual-coil defibrillator leads, 31 (18.0%) right atrial leads, 24 (13.9%) right ventricular leads and three (1.7%) malfunctional coronary sinus left ventricular pacing leads. The mean age of leads was 99.2±65.6 months. The implantation of new leads after crossing the venous stenosis/obstruction was successful in 98 (92.4%) cases. Postoperative complications were pocket hematoma in two cases and wound infection in one case. No peri-operative and no immediate postoperative death was recorded. One intraoperative superior vena cava tear was treated by immediate thoracotomy and surgical repair.
In a single-center study on LLE in the presence of supra-cardiac occlusion of the central veins for CIED lead upgrade and revision we could demonstrate a low procedural complication rate with no procedural deaths. Most of the leads could be completely extracted to revise or upgrade the system. Our study showed a low complication rate, with acceptable mortality rates.</description><subject>Biology and Life Sciences</subject><subject>Cardiac patients</subject><subject>Care and treatment</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Demography</subject><subject>Drafting software</subject><subject>Electronic equipment</subject><subject>Engineering and Technology</subject><subject>Guide rails</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Implants, Artificial</subject><subject>Lasers</subject><subject>Lead</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Occlusion</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prosthesis</subject><subject>Quality of life</subject><subject>Revisions</subject><subject>Sheaths</subject><subject>Success</subject><subject>Surgery</subject><subject>Transplants & implants</subject><subject>Veins & 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Artificial</topic><topic>Lasers</topic><topic>Lead</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Occlusion</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prosthesis</topic><topic>Quality of life</topic><topic>Revisions</topic><topic>Sheaths</topic><topic>Success</topic><topic>Surgery</topic><topic>Transplants & implants</topic><topic>Veins & arteries</topic><topic>Venous access</topic><topic>Wire</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al-Maisary, Sameer</creatorcontrib><creatorcontrib>Romano, Gabriele</creatorcontrib><creatorcontrib>Karck, Matthias</creatorcontrib><creatorcontrib>De Simone, Raffaele</creatorcontrib><creatorcontrib>Kremer, Jamila</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central 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One</addtitle><date>2021-05-14</date><risdate>2021</risdate><volume>16</volume><issue>5</issue><spage>e0251829</spage><epage>e0251829</epage><pages>e0251829-e0251829</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The implantation of cardiac implantable electronic devices (CIED) has increased in the last decades with improvement in the quality of life of patients with cardiac rhythm disorders. The presence of bilateral subclavian, innominate or superior vena cava obstruction is a major limitation to device revision and/or upgrade.
This is retrospective study of patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Spectranetics Corporation, Colorado Springs, USA) with lead revision or upgrade using the laser sheath as a guide rail. Patients with known occlusion, severe stenosis or functional obstruction of the venous access vessels with indwelling leads were included in this study.
106 patients underwent percutaneous LLE with lead revision and/or upgrade. Preoperative known complete occlusion or severe stenosis of access veins was present in 23 patients (21.5%). More patients with implantable cardioverter-defibrillator (ICD) underwent LLE (64.1%) than patients with CRT-Ds (24.5%) and pacemaker patients (11.3%). In total 172 leads were extracted: 79 (45.9%) single-coil defibrillator leads, 35 (20.3%) dual-coil defibrillator leads, 31 (18.0%) right atrial leads, 24 (13.9%) right ventricular leads and three (1.7%) malfunctional coronary sinus left ventricular pacing leads. The mean age of leads was 99.2±65.6 months. The implantation of new leads after crossing the venous stenosis/obstruction was successful in 98 (92.4%) cases. Postoperative complications were pocket hematoma in two cases and wound infection in one case. No peri-operative and no immediate postoperative death was recorded. One intraoperative superior vena cava tear was treated by immediate thoracotomy and surgical repair.
In a single-center study on LLE in the presence of supra-cardiac occlusion of the central veins for CIED lead upgrade and revision we could demonstrate a low procedural complication rate with no procedural deaths. Most of the leads could be completely extracted to revise or upgrade the system. Our study showed a low complication rate, with acceptable mortality rates.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33989335</pmid><doi>10.1371/journal.pone.0251829</doi><tpages>e0251829</tpages><orcidid>https://orcid.org/0000-0001-8758-1722</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Biology and Life Sciences Cardiac patients Care and treatment Complications Complications and side effects Demography Drafting software Electronic equipment Engineering and Technology Guide rails Heart Heart surgery Implants, Artificial Lasers Lead Medicine and Health Sciences Mortality Occlusion Patient outcomes Patients Prosthesis Quality of life Revisions Sheaths Success Surgery Transplants & implants Veins & arteries Venous access Wire |
| title | The use of laser lead extraction sheath in the presence of supra-cardiac occlusion of the central veins for cardiac implantable electronic device lead upgrade or revision |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T16%3A41%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20use%20of%20laser%20lead%20extraction%20sheath%20in%20the%20presence%20of%20supra-cardiac%20occlusion%20of%20the%20central%20veins%20for%20cardiac%20implantable%20electronic%20device%20lead%20upgrade%20or%20revision&rft.jtitle=PloS%20one&rft.au=Al-Maisary,%20Sameer&rft.date=2021-05-14&rft.volume=16&rft.issue=5&rft.spage=e0251829&rft.epage=e0251829&rft.pages=e0251829-e0251829&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0251829&rft_dat=%3Cgale_plos_%3EA661825676%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2527532297&rft_id=info:pmid/33989335&rft_galeid=A661825676&rft_doaj_id=oai_doaj_org_article_617aefa1a15f49e09e6231d59c84c1eb&rfr_iscdi=true |