Division of Cardiology, San Vincenzo Hospital, Contrada Sirina, Taormina, 38068 Messina, Italy.
Europace. 2009 Nov;11(11):1505-9. doi: 10.1093/europace/eup222. Epub 2009 Aug 7.
Recently, a mechanical single-sheath technique with a multiple venous entry-site approach for the removal of pacemaker and implantable defibrillator leads was reported to have a high success rate and few complications. In our institution, this technique of lead removal has been used since 2002. In this paper, we report our experience, with the aim of evaluating the effectiveness and safety of the proposed procedure.
This study is a retrospective analysis of the case records of all patients referred to our institution for transvenous lead extraction, according to class I or II Heart Rhythm Society indications. Over 7 years, 300 consecutive patients underwent procedures for transvenous removal of 518 leads. The most frequent indication for extraction was infection (74%). Complete removal of 502 (96.9%) leads and partial removal of 10 leads (1.9%) were achieved. Six leads (1.2%) could not be removed. All defibrillation coils and coronary sinus leads were successfully removed. There were no procedure-related deaths but only one major complication (0.3%).
Our experience shows that the proposed mechanical technique is very effective and associated with few serious complications, thus confirming previous findings. This approach may be reproduced in other settings with very satisfactory results.
最近，一种机械性单鞘管多静脉入路方法用于移除起搏器和植入式除颤器导线，报道称该方法成功率高，并发症少。自 2002 年以来，我们医院一直在使用这种导线移除技术。本文报告我们的经验，旨在评估该方法的有效性和安全性。
本研究回顾性分析了因符合 I 类或 II 类心律学会适应证而转诊至我院行经静脉导线移除术的所有患者的病历。7 年间，连续 300 例患者接受了 518 根导线的经静脉移除术。最常见的移除适应证为感染（74%）。成功移除 502 根（96.9%）导线和部分移除 10 根（1.9%）导线，6 根（1.2%）导线无法移除。所有除颤线圈和冠状窦导线均成功移除。无手术相关死亡病例，但仅发生 1 例严重并发症（0.3%）。
我们的经验表明，所提出的机械性技术非常有效，且严重并发症较少，与既往研究结果一致。在其他环境中采用该方法可能会取得非常满意的效果。
