Innovative Approach to Transvenous Lead Extraction: Bioptome and Snare Technique Without Additional Venous Access.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-05-06 DOI:10.1111/pace.15191

Chandan Sharma, Gautam Sharma

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引用次数: 0

Abstract

Background: Transvenous lead extraction (TLE) is recognized as an effective method of lead extraction, but can be challenging with old and tined pacemaker leads.

Case summary: We present the case of a 44-year-old male with cardiovascular implantable electronic device (CIED) infection who underwent TLE of his 15-year-old tined pacemaker leads using a novel approach. A carotid shuttle sheath with the tip fashioned into a bevel shape was used as a makeshift dilator to dissect and free the leads from adhesions. A bioptome, introduced through the TightRail sheath, was employed to dislodge the right ventricular (RV) lead tip, while a snare introduced subsequently through the same access was used to grip the distal end of the RV lead. The lead was extracted using the snare without the need for additional femoral or jugular access.

Conclusion: To the best of our knowledge, the use of this bioptome and snare technique, through the TightRail sheath, without employing femoral or jugular access for lead extraction, has not been previously reported. This case highlights the importance of innovative techniques in successfully addressing challenging TLE cases.

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经静脉铅提取的创新方法：无需额外静脉通道的生物组和陷阱技术。

背景：经静脉铅提取（TLE）被认为是一种有效的铅提取方法，但对于旧的和定时的起搏器导线可能具有挑战性。病例总结：我们报告一例44岁男性心血管植入式电子设备（CIED）感染患者，采用一种新颖的方法对其15岁的起搏器导联进行了TLE。颈动脉穿梭鞘顶端呈斜角状，用作临时扩张器，以解剖和释放粘连的导联。通过TightRail鞘引入的生物组被用来移除右心室（RV）导联尖端，而随后通过相同的通道引入的圈套被用来抓住RV导联的远端。使用诱捕器取出铅，不需要额外的股骨或颈静脉通道。结论：据我们所知，使用这种生物组和圈套技术，通过TightRail鞘，不使用股骨或颈静脉通道进行铅提取，以前没有报道。这个案例强调了创新技术在成功解决具有挑战性的TLE案例中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.