Lead Removal Without Extraction Tools: A Single-Center Experience
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| Format: | Artículo científico |
| Sprache: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2019
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| author | Neiberg de Alcantara Lima |
| author_facet | Neiberg de Alcantara Lima |
| contents | Lead Removal Without Extraction Tools: A Single-Center Experience Neiberg de Alcantara Lima Gisele Schinaider Cunha Natalia Soares de Menezes Evilásio Leobino da Silva Carol Cavalcante de Vasconcelos Lima Stela Maria Vitorino Sampaio Medicina Lasers Traction Pacemaker Artificial Retrospective Studies 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. 2019 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398966769014 https://www.redalyc.org/journal/3989/398966769014/ https://www.redalyc.org/journal/3989/398966769014/html/ https://www.redalyc.org/journal/3989/398966769014/398966769014.epub https://www.redalyc.org/journal/3989/398966769014/movil 10.21470/1678-9741-2018-0275 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.34 |
| format | Artículo científico |
| id | redalyc_398966769014 |
| institution | Redalyc |
| language | en |
| publishDate | 2019 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Lead Removal Without Extraction Tools: A Single-Center Experience Neiberg de Alcantara Lima Medicina Lasers Traction Pacemaker Artificial Retrospective Studies Lead Removal Without Extraction Tools: A Single-Center Experience Neiberg de Alcantara Lima Gisele Schinaider Cunha Natalia Soares de Menezes Evilásio Leobino da Silva Carol Cavalcante de Vasconcelos Lima Stela Maria Vitorino Sampaio Medicina Lasers Traction Pacemaker Artificial Retrospective Studies 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. 2019 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398966769014 https://www.redalyc.org/journal/3989/398966769014/ https://www.redalyc.org/journal/3989/398966769014/html/ https://www.redalyc.org/journal/3989/398966769014/398966769014.epub https://www.redalyc.org/journal/3989/398966769014/movil 10.21470/1678-9741-2018-0275 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.34 |
| title | Lead Removal Without Extraction Tools: A Single-Center Experience |
| topic | Medicina Lasers Traction Pacemaker Artificial Retrospective Studies |
| url | https://www.redalyc.org/articulo.oa?id=398966769014 https://www.redalyc.org/journal/3989/398966769014/ https://www.redalyc.org/journal/3989/398966769014/html/ https://www.redalyc.org/journal/3989/398966769014/398966769014.epub https://www.redalyc.org/journal/3989/398966769014/movil |