Percutaneous Extraction of Infected Pacemaker/ICD Leads: What Are the Current Technological Advances and Results?
Transvenous removal of permanent pacing and implantable cardioverter-defibrillator (ICD) leads is today an effective and relatively safe technique; its use will probably spread in the future because of the increasing number of pacemaker- or ICD-related complications. Abandonment of functionless pacing leads is becoming relatively common because the performance of the leads decreases with the implant duration [1,2]. Infection is another complication of implanted devices; it is reported to occur in from 0% up to 19% of the patients [3,4]. Endocardial ICD leads seem to give rise to the same complications as pacing leads; in ICD patients lead malfunction may result in dangerously inappropriate therapy or none. Infections occurring after implantation of an ICD are reported at an incidence of 2%-7%. All these complications can be treated by percutaneous lead removal. The indications for the procedure have been codified [5, 6] and today’s techniques are effective. The success rate of transvenous removal in most reports is now more than 90%, with a low rate of serious, life-threatening complications. Despite these excellent results, however, efforts are still being made to improve both the techniques and the outcome of the procedures, in order to achieve better success rates and a lower incidence of complications.
KeywordsLead Removal Pace Lead Lead Extraction Mechanical Dilation Transjugular Approach
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