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Case Reports
. 2025 Sep 11;11(12):1293-1295.
doi: 10.1016/j.hrcr.2025.09.002. eCollection 2025 Dec.

Successful retrieval of a detached metallic tip of a tissue stabilization sheath during a transvenous lead extraction: A case report

Naoki Mori  1 , Hitoshi Minamiguchi  1 , Takashi Kanda  1 , Osamu Iida  1 , Yoshiharu Higuchi  1
Affiliations
Case Reports

Successful retrieval of a detached metallic tip of a tissue stabilization sheath during a transvenous lead extraction: A case report

Naoki Mori et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Cardiovascular implantable electronic device; Complications; Detachment of the metallic tip; Evolution steady sheath; Transvenous lead extraction.

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Conflict of interest statement

Dr Minamiguchi has received personal fees from Cook Medical. The other authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
Transvenous lead extraction procedures. A: The atrial lead was extracted using the 11-F Evolution RL sheath with the 11-F ESS. B: The metallic tip of the ESS became detached in the innominate vein (white arrow). C: The atrial lead tip was captured using a Needle’s Eye Snare. D: The detached metallic tip (white arrow) was pushed into the 27-F MDS. E and F: The detached metallic tip was retrieved while maintaining its entrapment with a 7-mm balloon. G: The red arrow indicates the site of the detached metallic tip of the ESS bonded using a medical-grade adhesive. ESS = Evolution steady sheath; MDS = Micra delivery sheath.
Figure 2
Figure 2
A and B: The 11-F ESS could be easily inserted into both the 27-F MDS and the 24-F DrySeal sheath. C and D: Insertion of the 13-F ESS into either the 27-F MDS or the 24-F DrySeal sheath proved somewhat challenging. ESS = Evolution steady sheath; MDS = Micra delivery sheath.
See this image and copyright information in PMC

References

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    1. Blomström-Lundqvist C., Traykov V., Erba P.A., et al. European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat CIED infections. Europace. 2020;22:515–549. - PMC - PubMed
    1. Tabata H., Okada A., Kobayashi H., et al. Usefulness of the controlled-rotation dilator sheath “Evolution RL” for extraction of old leads in two Japanese centers—an experience in use. J Cardiol. 2022;80:339–343. - PubMed
    1. Gabriels J., Chang D., Donnelly J., et al. When bigger is better: novel use of a 27 F leadless pacemaker delivery sheath for femoral lead extractions. Heart Rhythm. 2020;17:152–157. - PubMed

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