Pacemaker/ICD Lead Extraction Using the Excimer Laser Sheath: What Are the Advantages and What Are the Risks?

  • G. Gasparini
  • A. Rossillo
  • F. Giada
  • A. Corrado
  • A. Raviele
Conference paper


Since 1965 transvenous lead implantation for cardiac pacing has been the routine treatment for bradyarrhythmias. At the end of 1980s, the implantable car- dioverter defibrillator (ICD) was considered the first-line therapy for tach- yarrhythmia management, and in recent years new ICD indications for the primary prevention of sudden death have been added. Moreover, biventricular pacing for the treatment of congestive heart failure has been recently introduced. Thus, the number of implantable devices with a growing number of leads is increasing day after day.


Excimer Laser Left Internal Mammary Artery Laser Group Biventricular Pace Implantable Defibrillator 
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  1. 1.
    Byrd CL, Schwartz SJ, Hedin N (1992) Lead extraction: indications and techniques. Cardiol Clin 10:735–748PubMedGoogle Scholar
  2. 2.
    North American Society of Pacing and Electrophysiology Lead Extraction Conference Faculty (2000) Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads: indications, facilities, training. Pacing Clin Electrophysiol 23:544–551CrossRefGoogle Scholar
  3. 3.
    Smith HH, Fearnot NE, Byrd CL et al (1994) Five-year experience with intravascular lead extraction. Pacing Clin Electrophysiol 1711:2016–2020CrossRefGoogle Scholar
  4. 4.
    Tyers GFO (2000) Lead extraction methods (abstr). Europace l(suppl):D45Google Scholar
  5. 5.
    Manolis AS, Maounis TN, Vassilikos V, Chiladakis J, Melita-Manolis H, Cokkinos DV (2001) Ancillary tools in pacemaker and defibrillator lead extraction using a novel lead removal system. Pacing Clin Electrophysiol 24:282–287PubMedCrossRefGoogle Scholar
  6. 6.
    Kennergren C, Schaerf RHM, Duncan Sellers T et al (2000) Cardiac lead extraction with a novel locking stylet. J Interv Cardiac Electrophysiol 4:591–593CrossRefGoogle Scholar
  7. 7.
    Epstein AE, Kay GN, Plumb VJ, Dailey SM, Anderson PG (1998) Gross and microscopic pathological changes associated with nonthoracotomy implantable defibrillator leads. Circulation 98:1517–1524PubMedCrossRefGoogle Scholar
  8. 8.
    Reiser C, Taylor K (1997) Excimer laser catheter for pacing lead removal. Soc Photooptic Instrum Eng Proc 2970:80–84Google Scholar
  9. 9.
    Reiser C, Taylor K, Lippincott R (1998) Large laser sheaths for pacing and defibrillator lead removal. Lasers Surg Med 22:42–45PubMedCrossRefGoogle Scholar
  10. 10.
    Kennergren C (1998) First European experience using excimer laser for the extraction of permanent pacemakerleads. Pacing Clin Electrophysiol 21:268–270PubMedCrossRefGoogle Scholar
  11. 11.
    Bracke FA, Meijer A, van Gelder B (1998) Learning curve characteristics of pacing lead extraction with a laser sheath. Pacing Clin Electrophysiol 21:2309–2313PubMedCrossRefGoogle Scholar
  12. 12.
    Wilkoff BL, Byrd CL, Love CJ et al (1999) Pacemaker lead extraction with the laser sheath: results of the Pacing Lead Extraction with the Excimer Sheath (PLEXES) trial. J Am Coll Cardiol 33:1671–1676PubMedCrossRefGoogle Scholar
  13. 13.
    Kennergren C, on behalf of the PLESSE (Pacing Lead Extraction Surveillance Study in Europe) investigators group (1999) Excimer laser assisted extraction of permanent pacemaker and ICD leads: present experiences of a European multi-centre study. Eur J Cardiothoracic Surg 15:856–860CrossRefGoogle Scholar
  14. 14.
    Epstein LM, Byrd CL, Wilkoff BL et al (1999) Initial experience with larger laser sheaths for the removal of transvenous pacemaker and implantable defibrillator leads. Circulation 100:516–525PubMedCrossRefGoogle Scholar
  15. 15.
    Levy T, Walker S, Paul V (1999) Initial experience in the extraction of chronically implanted pacemaker leads using excimer laser sheath. Heart 82:101–104PubMedGoogle Scholar
  16. 16.
    Parsonnet V, Roelke M, Trivedi A, Rizvi SA, Pervez A (2001) Laser extraction of entrapped leads. Pacing Clin Electrophysiol 24:329–332PubMedCrossRefGoogle Scholar
  17. 17.
    Bracke FA, Meijer A, van Gelder B (2001) Endovascular extraction techniques. Part 3: results and indications in patients with an ICD. Neth Heart J 9:117–122Google Scholar
  18. 18.
    Gilligan DM, Dan D (2001) Excimer laser for pacemaker and defibrillator lead extraction: techniques and clinical results. Lasers Med Sci 16:113–121PubMedCrossRefGoogle Scholar
  19. 19.
    Byrd CL, Wilkoff BL, Love CJ, Duncan Sellers T, Reiser C (2002) Clinical study of the laser sheath for lead extraction: the total experience in the United States. Pacing Clin Electrophysiol 25:804–808PubMedCrossRefGoogle Scholar
  20. 20.
    Bracke FA, Meijer A, van Gelder B (2002) Extraction of pacemaker and implantable cardioverter defibrillator leads: patients and lead characteristics in relation to the requirement of extraction tools. Pacing Clin Electrophysiol 25:1037–1040PubMedCrossRefGoogle Scholar
  21. 21.
    Bracke FALE, Meijer A, van Gelder LM (2002) Use of a laser sheath to obtain venous access in pacemaker lead-related obstruction without extraction of the lead. Europace 4:67–68PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • G. Gasparini
    • 1
  • A. Rossillo
    • 1
  • F. Giada
    • 1
  • A. Corrado
    • 1
  • A. Raviele
    • 1
  1. 1.O.U. of CardiologyUmberto I HospitalMestre-Venice

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