Department of Cardiology, Ondokuz Mayıs University School of Medicine, Samsun 55139, Turkey.
Medicina (Kaunas). 2024 Aug 21;60(8):1360. doi: 10.3390/medicina60081360.
: The number of cardiac pacemakers being used has increased in recent decades, and this increase has led to a rise in device-related complications, requiring percutaneous device extraction. Our aim was to present our single-center clinical experience in percutaneous lead extractions. : We analyzed an observational retrospective cohort study of 93 patients for the transvenous removal of a total of 163 endocardial leads. We evaluated the device details, indications, lead characteristics, extraction methods, complications, reimplantation procedure, follow-up data, effectiveness, and safety. : Patients' mean age was 68.6 ± 11.6 years. Lead extraction indications were pocket infection in 33 (35.5%), lead dysfunction in 33 (35.5%), and system upgrade in 21 (23%) cases, and lead endocarditis in 6 (6%) cases. The duration from implantation to extraction time was a detected median of 43 (24-87) months. The most common retracted lead type was the RV defibrillator lead (62%), and the lead fixation type was active for one hundred (61%) patients. A new device was inserted in 74 (80%) patients, and the device type was most commonly a CRT-D (61%). Patients were followed up at a median of 17 (8-36) months, and 18 patients (19%) died at follow-up. Complete procedural success was obtained in 78 (84%) patients, and clinical procedural success was obtained in 83 (89%) patients. Procedural failure was detected in 15 (16%) patients. Major and minor complications were detected in 10 (11%) and 6 (6.5%) patients, respectively. The most common minor complication was pocket hematoma. : Our experience suggests that transvenous lead extraction has a high success rate with an acceptable risk of procedural complications. The simple manual traction method has a high rate of procedural success, despite a high dwell time of the lead.
: 近几十年来，心脏起搏器的使用数量有所增加，这导致与器械相关的并发症增加，需要进行经皮器械取出。我们旨在介绍我们在经皮导线取出方面的单中心临床经验。: 我们分析了一项回顾性观察队列研究，该研究纳入了 93 例患者，总共进行了 163 次心内膜导线的经静脉取出。我们评估了器械细节、适应证、导线特征、取出方法、并发症、再植入程序、随访数据、有效性和安全性。: 患者的平均年龄为 68.6 ± 11.6 岁。导线取出的适应证包括 33 例（35.5%）的囊袋感染、33 例（35.5%）的导线功能障碍、21 例（23%）的系统升级和 6 例（6%）的导线心内膜炎。从植入到取出的时间中位数为 43（24-87）个月。最常见的缩回导线类型为 RV 除颤器导线（62%），导线固定类型为主动固定的有 100 例（61%）。74 例（80%）患者中插入了新的器械，最常见的器械类型是 CRT-D（61%）。患者的中位随访时间为 17（8-36）个月，随访时 18 例（19%）患者死亡。78 例（84%）患者获得了完全程序成功，83 例（89%）患者获得了临床程序成功。15 例（16%）患者出现程序失败。10 例（11%）和 6 例（6.5%）患者分别出现了主要和次要并发症。最常见的轻微并发症是囊袋血肿。: 我们的经验表明，经皮导线取出具有较高的成功率，程序并发症的风险可以接受。尽管导线留置时间较长，但简单的手动牵引方法具有较高的程序成功率。
