Transvenous lead extraction via the inferior approach using a gooseneck snare versus simple manual traction

Uk Jo, Jun Kim, You Mi Hwang, Ji Hyun Lee, Min Su Kim, Hyung Oh Choi, Woo Seok Lee, Chang Hee Kwon, Gi Young Ko, Hyun Ki Yoon, Gi Byoung Nam, Kee Joon Choi, You Ho Kim

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background and Objectives: The number of patients with cardiac implantable electronic devices needing lead extraction is increasing for various reasons, including infections, vascular obstruction, and lead failure. We report our experience with transvenous extraction of pacemaker and defibrillator leads via the inferior approach of using a gooseneck snare as a first-line therapy and compare extraction using a gooseneck snare with extraction using simple manual traction. Subjects and Methods: The study included 23 consecutive patients (43 leads) who underwent transvenous lead extraction using a gooseneck snare (group A) and 10 consecutive patients (17 leads) who underwent lead extraction using simple manual traction (group B). Patient characteristics, indications, and outcomes were analyzed and compared between the groups. Results: The dwelling time of the leads was longer in group A (median, 121) than in group B (median, 56; p=0.000). No differences were noted in the overall procedural success rate (69.6% vs. 70%), clinical procedural success rate (82.6% vs. 90%), and lead clinical success rate (86% vs. 94.1%) between the groups. The procedural success rates according to lead type were 89.2% and 100% for pacing leads and 66.7% and 83.3% for defibrillator leads in groups A and B, respectively. Major complications were noted in 3 (mortality in 1) patients in group A and 2 patients in group B. Conclusion: Transvenous extraction of pacemaker leads via an inferior approach using a gooseneck snare was both safe and effective. However, stand-alone transvenous extraction of defibrillator leads using the inferior approach was suboptimal.

Original languageEnglish
Pages (from-to)186-196
Number of pages11
JournalKorean Circulation Journal
Volume46
Issue number2
DOIs
StatePublished - Mar 2016

Keywords

  • Artificial
  • Defibrillators
  • Device removal
  • Implantable
  • Pacemaker

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