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. 2020 Feb 14;36(2):343-350.
doi: 10.1002/joa3.12310. eCollection 2020 Apr.

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Patrizio Mazzone  1 , Francesco Melillo  1 , Andrea Radinovic  1 , Alessandra Marzi  1 , Gabriele Paglino  1 , Paolo Della Bella  1 , Giosuè Mascioli  2
Affiliations

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Patrizio Mazzone et al. J Arrhythm. .

Abstract

Aim: The aim of this study is to assess the safety and efficacy of the new bidirectional rotational mechanical sheath TightRail™ (Spectranetics) for lead extraction.

Methods and results: This is a bicentric prospective study that included patients who underwent a transvenous lead extraction (TLE) in two Italian centers (San Raffaele Hospital and Humanitas Gavazzeni Hospital). From November 2016 to December 2018, 26 patients underwent a TLE procedure in which the TightRail™ was used. The new TightRail Sub-C was used in 20 (76%) patients to overcome the fibrosis between the vessel and the first rib. Median age was 69 (IQR 60.7-79.5) years. The indication for TLE were infection (57.7%) or lead dysfunction (42.3%). A total of 57 leads (range 1-4), 40 of which using the TightRail (range 1-4), were extracted. Overall mean implant duration was 98.2.0 ± 66.5 months. Mean age of the lead extracted with the TightRail sheath was 99.1 ± 70.2 months and was higher compared to that of the leads extracted manually (84.4 ± 60.3 months, P = .001). The overall clinical success was 100% and complete procedural success without the use of a snare was achieved in 98.3%. There were no cases of death or major complications and only two minor complications occurred. All patients were event-free at 6-month follow-up.

Conclusion: This initial experience using the TightRail™ suggests a high safety and efficacy profile for extractions in a wide range of lead age.

Keywords: lead extraction; rotational sheath.

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Conflict of interest statement

The authors declare no conflict of interests for this article.

Figures

Figure 1
Figure 1
The TightRail dilator sheath is composed by an inner and outer shaft and a handled drive mechanism used to rotate the inner shaft
See this image and copyright information in PMC

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