Ma Wingtung M, Warburton Thomas M, Sim Alexandra, Watson Alasdair, Subbiah Rajesh, Evans David
Faculty of Medicine, University of New South Wales, Sydney, New South Wales.
Department of Vascular Surgery, St Vincent's Hospital Sydney, Darlinghurst, New South Wales.
J Vasc Surg Cases Innov Tech. 2025 Jun 19;11(5):101885. doi: 10.1016/j.jvscit.2025.101885. eCollection 2025 Oct.
Transvenous lead extraction for cardiac implantable electronic devices remains a high-risk procedure among profound evolutions of extraction techniques. Laser-assisted transvenous lead extraction is required with prolonged lead dwell times or failed mechanical extraction. Tertiary subspecialty support is crucial to mediate the small but significant risk of cardiovascular morbidity and mortality. We report a case of laser lead extraction complicated by internal mammary artery perforation and fistulization, salvaged with endovascular intervention. Multidisciplinary subspecialty support, skills, and infrastructure should be used for all these extractions.
在心脏植入式电子设备经静脉导线拔除技术的重大进展中，经静脉导线拔除仍然是一项高风险操作。对于导线留置时间延长或机械拔除失败的情况，需要进行激光辅助经静脉导线拔除。三级专科支持对于降低心血管发病率和死亡率虽小但显著的风险至关重要。我们报告一例激光导线拔除并发乳内动脉穿孔和瘘形成的病例，通过血管内介入治疗得以挽救。所有这些拔除操作都应利用多学科专科支持、技术和基础设施。
