2nd Department of Cardiology, Medical University of Silesia in Katowice, School of Medicine with the Division of Dentistry in Zabrze, Poland.
Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Kielce, Poland.
Biomed Res Int. 2018 Dec 18;2018:8796704. doi: 10.1155/2018/8796704. eCollection 2018.
Transvenous lead extraction (TLE) is the gold standard in the management of patients with cardiac implantable electronic devices (CIED)-related complications. Knowledge of TLE risk factors is very important.
Clinical data from 1915 patients undergoing TLE at the Reference Center between 2006 and 2015 were analyzed. The effects of clinical and procedure-related factors on the development of major (MJC) and minor (MIC) complications and survival after TLE were evaluated.
MJC were caused mainly by lead implant duration, presence of abandoned leads, multiple procedures preceding TLE, and any technical problem during TLE. Of clinical factors female gender and anemia increased the risk of MJC. MIC were reported in patients with the first implantation of CIED under the age of 30 and after sternotomy analysis of 30-day survival after procedure demonstrated a significant effect of clinical factors and lead dwell times, previous unsuccessful TLE, and MIC.
Efficacy and safety of TLE depend mainly on procedure-related factors. This knowledge is essential for preventing MJC and MIC. Mortality at 30 days following TLE is mainly associated with the clinical factors; however, there was also a significant effect of lead dwell time and periprocedural complications on the short-term prognosis of patients undergoing TLE.
经静脉心脏植入电子设备（CIED）相关并发症患者的管理中，经静脉导线拔除术（TLE）是金标准。了解 TLE 的风险因素非常重要。
分析了 2006 年至 2015 年间在参考中心接受 TLE 的 1915 例患者的临床数据。评估了临床和手术相关因素对主要（MJC）和次要（MIC）并发症发展以及 TLE 后生存的影响。
MJC 主要由导线植入时间、废弃导线的存在、TLE 前的多次手术以及 TLE 期间的任何技术问题引起。在临床因素中，女性和贫血增加了 MJC 的风险。MIC 见于年龄在 30 岁以下的首次植入 CIED 的患者，以及胸骨切开术后。对 30 天后的生存率进行分析，发现临床因素、导线留置时间、以前不成功的 TLE 以及 MIC 对疗效有显著影响。
TLE 的疗效和安全性主要取决于手术相关因素。这些知识对于预防 MJC 和 MIC 至关重要。TLE 后 30 天的死亡率主要与临床因素相关，但导线留置时间和围手术期并发症对 TLE 患者的短期预后也有显著影响。
