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Personal Technique and Experience: The Pisa Approach

  • Maria Grazia Bongiorni

Abstract

Technological advances in transvenous lead removal can be achieved by improving the materials and tools for lead extraction or modifying the techniques and approaches. I started the activity of transvenous lead removal in S. Chiara Hospital in Pisa, Italy, in December 1989; since then, with my coworkers, we have managed more than 2,500 pacing and implantable cardioverter-defibrillator (ICD) leads [1]. From the beginning, the technique and approaches have been continuously changed and improved, and by the beginning of 1997, we considered technique maturation to be complete [2]. From 1994 to 1996, we experienced the internal jugular approach to remove free-floating leads, and at the beginning of 1997, we started using it also in case of standard technique failure [3]. The first techniques I learned and applied for lead removal were traction with locking stylet, counter-pressure, and countertraction, as described by Byrd et al. [4], using polypropylene sheaths. Very often, we experienced the inability to insert the stylet up to the lead tip because of lead damage or stylet unlocking during traction; moreover, the force necessary to apply counterpressure and countertraction was discouraging.

Keywords

Internal Jugular Vein Lead Removal Lead Extraction Large Sheath Sheath Rotation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • Maria Grazia Bongiorni
    • 1
  1. 1.2nd Cardiovascular Department AOUPSanta Chiara University HospitalPisaItaly

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