Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-05-26

AUTHORS

Patric Kröpil, Rotem S. Lanzman, Falk R. Miese, Dirk Blondin, Joachim Winter, Axel Scherer, Günter Fürst

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. More... »

PAGES

345-351

References to SciGraph publications

  • 2005-06. Venous Thrombosis and Stenosis After Implantation of Pacemakers and Defibrillators in JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
  • 2007-10-23. Endovascular Management of Lost or Misplaced Intravascular Objects: Experiences of 12 Years in CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00270-010-9887-x

    DOI

    http://dx.doi.org/10.1007/s00270-010-9887-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1008032301

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/20502898


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