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. 2019 Aug 27;34(4):458-463.
doi: 10.21470/1678-9741-2018-0275.

Lead Removal Without Extraction Tools: A Single-Center Experience

Neiberg de Alcantara Lima  1   2 , Gisele Schinaider Cunha  3 , Natalia Soares de Menezes  2 , Evilásio Leobino da Silva Junior  2 , Carol Cavalcante de Vasconcelos Lima  4 , Stela Maria Vitorino Sampaio  2
Affiliations

Lead Removal Without Extraction Tools: A Single-Center Experience

Neiberg de Alcantara Lima et al. Braz J Cardiovasc Surg. .

Abstract

Introduction: Indications for cardiac devices have been increasing as well as the need for lead extractions as a result of infections, failed leads and device recalls. Powered laser sheaths, with a global trend towards the in-creasingly technological tools, meant to improve the procedure's outcome but have economic implications.

Objective: The aim of this study is to demonstrate the experience of a Bra-zilian center that uses simple manual traction in most lead removals per-formed annually, questioning the real need for expensive and technically challenging new devices.

Methods: This retrospective observational study included 35 patients who had a transvenous lead extraction in the period of a year between January 1998 and October 2014 at Hospital de Messejana Dr. Carlos Alberto Studart Gomes, in Fortaleza, CE, Brazil. Data were collected through a records review. They were evaluated based on age, type of device, dwelling time, indication for removal, technique used and immediate outcomes.

Results: The median dwelling time of the devices was 46.22 months. Infec-tion, lead fracture and device malfunction were the most common indica-tions. Simple traction was the method of choice, used in 88.9% of the pro-cedures. Manual traction presented high success rates, resulting in com-plete removal without complications in 90% of the cases.

Conclusion: This article suggests that lead extraction by simple manual traction can still be performed effectively in countries with economic diffi-culties as a first attempt, leaving auxiliary tools for a second attempt in case of failure or contraindications to the simple manual traction technique.

Keywords: Lasers; Pacemaker, Artificial; Retrospective Studies; Traction.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
Atrial lead manual traction extraction.
Fig. 2
Fig. 2
Outcomes of the procedures.
See this image and copyright information in PMC

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