Combined Percutaneous Mechanical Aspiration and Transvenous Lead Extraction in CIED-Related Endocarditis: A Case Report.

Abstract

Introduction: Current guidelines recommend complete removal of a cardiac implantable electronic device (CIED) in infective endocarditis (IE), with surgical extraction indicated for large vegetations (> 20-25 mm).

Case: We report a 68-year-old patient with CIED-related IE and a 3 × 3.5 cm lead vegetation successfully treated by percutaneous mechanical aspiration (PMA) using the FlowTriever system, followed by transvenous lead extraction (TLE). The combined approach achieved complete removal without complications or recurrence.

Conclusion: This case highlights PMA as a feasible, less invasive alternative to surgery in selected high-risk patients, enabling safe TLE by reducing vegetation size and embolic risk.