Abstract
BackgroundLead laser extraction is a well-established method for removing unwanted leads with low morbidity and mortality.ObjectiveIn this observational study, we documented our experience with venous occlusion after lead laser extraction.MethodsRetrospective data of patients who underwent lead laser extraction between May 2010 and August 2018 was analyzed. Two subgroups of patients were identified. First group represented patients after lead laser extraction who suffered postoperative venous occlusion. Second group represents patients after lead laser extraction, who has documented patent venous access after lead laser extraction.Results219 patients underwent percutaneous laser lead extraction. The mean age of patients was 65 ± 14 years. Of these patients, 74% were male. The Most common indication for extraction was Nonfunctional lead (45.2%, n = 99) followed by pocket infection with 33.8% and endocarditis (17.3%). A total number of 447 leads underwent laser extraction. In 7.8% of the patients, lead extraction was partially successful and lead extraction was not successful in only 2.3% of the patients. Only 13 patients developed a documented venous occlusion postoperatively and 26 patients has documented absence of venous occlusion, of whom 17 were under oral anticoagulation.ConclusionLead laser extraction may lead to venous occlusion, which is mostly asymptomatic but it prevents future lead implantation. The use of oral anticoagulant may prevent postoperative venous occlusion.
Highlights
Lead laser extraction is a well-established method for removing unwanted leads with low morbidity and mortality
Lead laser extraction may lead to venous occlusion, which is mostly asymptomatic but it prevents future lead implantation
We report our experience in CEID extraction using the 80 Hz high frequency laser sheaths to evaluate its safety and efficacy and the risk of venous thrombosis following extraction
Summary
Lead laser extraction is a well-established method for removing unwanted leads with low morbidity and mortality. The implantation of Cardiac implantable electronic devices (CIED) has increased in the last decades due the benefit of increasing survival and improving the quality of life in patients with cardiac rhythm disorders. This wide spread use is associated with an increase in post-implantation complication of which is infection and dysfunction the most prominent ones due to its effect on therapy strategies and the life expectancy of the affected. The evidence of venous injury during lead laser extraction was documented and until now and no serious consequences were presented [10]. We report our experience in CEID extraction using the 80 Hz high frequency laser sheaths to evaluate its safety and efficacy and the risk of venous thrombosis following extraction
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