Wessex Cardiothoracic Unit, Southampton University Hospitals NHS Trust, Southampton SO16 6YD, UK.
Europace. 2009 Nov;11(11):1501-4. doi: 10.1093/europace/eup263. Epub 2009 Sep 29.
Both electrosurgical dissection (EDS) and laser tools are effective in the extraction of chronic implanted endovascular leads. It is unclear which is superior. We undertook a retrospective single-centre study to assess this.
In our institution from 2000 to 2004, all extractions requiring an ablative sheath were performed using the EDS system. In 2004, an excimer laser system was acquired, which became the first choice. Consecutive patients undergoing extraction requiring an ablative sheath (EDS or laser) were studied. From 2000 to 2007, 140 leads were extracted from 74 patients (EDS 31 and laser 43). Procedural success was non-significantly higher in the laser vs. the EDS group (95 vs. 87%). In the EDS group, one patient suffered tamponade requiring surgery; in the laser group, one patient suffered a significant pericardial effusion treated conservatively. There were no deaths. Procedure and fluoroscopy times were similar between groups. More patients were referred for primary surgical extraction in the EDS vs. the laser era (7 vs. 0, P = 0.003).
Lead extraction using an ablative sheath is safe and effective. In our small study, there were no significant differences between EDS and laser sheaths in terms of success, time, or safety.
电外科解剖（EDS）和激光工具在提取慢性植入血管内导线方面均有效。目前尚不清楚哪种方法更优。我们进行了一项回顾性单中心研究来对此进行评估。
在我们机构，2000 年至 2004 年，所有需要消融鞘的提取均使用 EDS 系统进行。2004 年，获得了准分子激光系统，该系统成为了首选。连续接受需要消融鞘（EDS 或激光）提取的患者进行了研究。2000 年至 2007 年，74 名患者中有 140 根导线被提取（EDS 31 根，激光 43 根）。激光组与 EDS 组相比，手术成功率略高（95% vs. 87%），但无统计学差异。在 EDS 组，1 例患者发生需手术治疗的填塞；在激光组，1 例患者发生大量心包积液，给予保守治疗。无死亡病例。两组之间的手术和透视时间相似。在 EDS 时代，比激光时代有更多的患者需要进行初次外科提取（7 例 vs. 0 例，P = 0.003）。
使用消融鞘进行导线提取是安全有效的。在我们的小研究中，在成功率、时间或安全性方面，EDS 和激光鞘之间没有显著差异。
