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Lead removal without extraction tools: a single-center experience
Lima, Neiberg de Alcantara; Cunha, Gisele Schinaider; Menezes, Natalia Soares de; Silva Junior, Evilásio Leobino da; Lima, Carol Cavalcante de Vasconcelos; Sampaio, Stela Maria Vitorino.
  • Lima, Neiberg de Alcantara; Western Michigan University. Michigan. US
  • Cunha, Gisele Schinaider; Universidade Federal do Ceará. Fortaleza. BR
  • Menezes, Natalia Soares de; Hospital de Messejana Dr. Carlos Alberto Studart Gomes. Fortaleza. BR
  • Silva Junior, Evilásio Leobino da; Hospital de Messejana Dr. Carlos Alberto Studart Gomes. Fortaleza. BR
  • Lima, Carol Cavalcante de Vasconcelos; Clínica Radiológica Mario de Assis. Fortaleza. BR
  • Sampaio, Stela Maria Vitorino; Hospital de Messejana Dr. Carlos Alberto Studart Gomes. Fortaleza. BR
Rev. bras. cir. cardiovasc ; 34(4): 458-463, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1020506
ABSTRACT
Abstract

Introduction:

Indications for cardiac devices have been increasing as well as the need for lead extractions as a result of infections, failed leads and device recalls. Powered laser sheaths, with a global trend towards the in-creasingly technological tools, meant to improve the procedure's outcome but have economic implications.

Objective:

The aim of this study is to demonstrate the experience of a Bra-zilian center that uses simple manual traction in most lead removals per-formed annually, questioning the real need for expensive and technically challenging new devices.

Methods:

This retrospective observational study included 35 patients who had a transvenous lead extraction in the period of a year between January 1998 and October 2014 at Hospital de Messejana Dr. Carlos Alberto Studart Gomes, in Fortaleza, CE, Brazil. Data were collected through a records review. They were evaluated based on age, type of device, dwelling time, indication for removal, technique used and immediate outcomes.

Results:

The median dwelling time of the devices was 46.22 months. Infec-tion, lead fracture and device malfunction were the most common indica-tions. Simple traction was the method of choice, used in 88.9% of the pro-cedures. Manual traction presented high success rates, resulting in com-plete removal without complications in 90% of the cases.

Conclusion:

This article suggests that lead extraction by simple manual traction can still be performed effectively in countries with economic diffi-culties as a first attempt, leaving auxiliary tools for a second attempt in case of failure or contraindications to the simple manual traction technique.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pacemaker, Artificial / Device Removal / Catheter-Related Infections Type of study: Observational study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2019 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Clínica Radiológica Mario de Assis/BR / Hospital de Messejana Dr. Carlos Alberto Studart Gomes/BR / Universidade Federal do Ceará/BR / Western Michigan University/US

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Full text: Available Index: LILACS (Americas) Main subject: Pacemaker, Artificial / Device Removal / Catheter-Related Infections Type of study: Observational study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2019 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Clínica Radiológica Mario de Assis/BR / Hospital de Messejana Dr. Carlos Alberto Studart Gomes/BR / Universidade Federal do Ceará/BR / Western Michigan University/US