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Sakamoto S, Baba K, Wakasa S, Yanagishita S, Irishio M, Yanagishita T, Yoshisako Y, Nakatani Y, Kataoka T, Fukuda D. Unique Extraction of a Fractured Pacemaker Lead Adhered to the Spermatic Vein. JACC Case Rep 2024; 29:102160. [PMID: 38264307 PMCID: PMC10801801 DOI: 10.1016/j.jaccas.2023.102160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/16/2023] [Accepted: 11/15/2023] [Indexed: 01/25/2024]
Abstract
Transvenous lead extraction has been increasingly recognized as a safe and effective method of lead extraction, but there are only few references for extracting leads migrating outside the heart. We present a successful extraction of a fractured pacemaker lead from the spermatic vein using several approaches and multiple tools.
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Affiliation(s)
- Shogo Sakamoto
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Kenji Baba
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Shiho Wakasa
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Shiori Yanagishita
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Moritoshi Irishio
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Tomoya Yanagishita
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka, Japan
| | - Yuta Yoshisako
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Yoshihiro Nakatani
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Toru Kataoka
- Department of Cardiovascular Medicine, Bellland General Hospital, Naka-ku, Sakai, Osaka, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka, Japan
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Zhou X, Ze F, Li D, Wang L, Duan J, Yuan C, He J, Guo J, Li X. Transfemoral extraction of pacemaker and implantable cardioverter defibrillator leads using Needle's Eye Snare: a single-center experience of more than 900 leads. Heart Vessels 2019; 35:825-834. [PMID: 31786644 DOI: 10.1007/s00380-019-01539-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/22/2019] [Indexed: 11/27/2022]
Abstract
The femoral approach with the Needle's Eye Snare (NES) is often used for bailout after failure of the superior approach for transvenous lead extraction (TLE). The safety and efficacy of the NES as a first-line tool for TLE remain unclear. The medical records of patients who underwent TLE via the femoral approach utilizing the NES from May 2014 to June 2019 in Peking University People's Hospital were retrospectively reviewed. Nine hundred and eighty-five leads were extracted in 492 patients (369 men; mean age 72.8 ± 29.0 years). The median (range) number of leads extracted per patient was 2 (1-6). The mean indwelling time of all extracted leads was 112.6 ± 52.0 months. The complete procedure success rate, clinical success rate, and failure rate were 94.1% (463/492), 97.8% (481/492), and 1.1% (11/492), respectively. Major complications including death occurred in nine patients (1.9%), of whom eight developed cardiac tamponade. Among these eight patients, emergency pericardiocentesis followed by rescue surgical repair if necessary was successful in 6 (75.0%) and failed in 2 (25.0%). No significant differences were found in the clinical success rate or major complications rate between patients with pacemakers and implantable cardioverter defibrillators, or between patients with infected and uninfected leads. A femoral approach with the NES is safe and effective for TLE of both pacing and defibrillator leads and could be considered a first-line approach. Cardiac tamponade was the most frequent cardiovascular complication. A strategy of emergency pericardiocentesis followed by a rescue surgical approach seems to be reasonable technique to treat a cardiac tamponade.
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Affiliation(s)
- Xu Zhou
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Feng Ze
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Ding Li
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Long Wang
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Jiangbo Duan
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Cuizhen Yuan
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Jinshan He
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Jihong Guo
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China
| | - Xuebin Li
- Department of Cardiac Electrophysiology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, China.
- Department of Cardiology, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 11 Xizhimen South Street, Beijing, 100044, China.
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