Abstract
Abstract Background Lead control has an essential role in successful transvenous lead extraction (TLE), however, there is limited data about leads without adequate control Objective The aim of the study was to assess the success rate, complexity, and safety of partially controlled lead extraction. Methods A single-center retrospective analysis of consecutive patients underwent TLE procedures was performed. Results From May 2012 to Aug 2019, 137 consecutive patients (76% male, mean age: 65 ± 15 years) underwent TLE procedures (273 leads, 93% infective indication, 37% with high voltage leads). Locking stylet was used in 83% (n = 224) of the leads. Advancement of the locking stylet all the way to the tip was not possible in 30.4% (n = 68) of the leads, resulting in partial control (LC- group). The mean age of the lead was significantly higher (11.06 +/- vs 7.76 +/- 6.3, p = 0.001) and the success rate was lower (76.1 % vs 93.2%, p = 0.001) in LC-. The need for femoral approach was more frequently in LC- leads (36.9% vs 16.2%, P= 0.001). Inadequate lead control was an independent predictor of lead extraction failure (OR: 5.27, 95% CI: 1.71-5.27, p= 0.004) and femoral approach (OR: 2.1, 95% CI: 1.054-4.08, p= 0.035). Three out of five major complications occurred in LC- group. Conclusions Partial lead control results in lower success rate and more complex TLE procedures.
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