扫描和光学显微镜下的心内膜铅绝缘磨损。

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Mateusz Ulman, Krzysztof Boczar, Katarzyna Holcman, Magdalena Ziąbka, Maciej Dębski, Jacek Lelakowski, Andrzej Ząbek
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引用次数: 0

摘要

背景:导线在心血管系统中的路径和相互作用受到各种因素的影响,包括植入技术。此外,这些导线由多种材料组成,随着时间的推移,其潜在的降解和磨损可能会加剧:我们的目的是调查移除经静脉导联后导联绝缘层的磨损情况,并确定导联最易受损的区域:我们对一家三级医疗中心在 2013 年 10 月 1 日至 2015 年 7 月 31 日期间接受经静脉导联切除术 (TLE) 的患者进行了前瞻性分析。具体来说,我们的检查重点是采用简单旋出和轻柔牵引技术取出的心内膜导联。随后利用扫描电子显微镜和光学显微镜对导联进行了评估:在接受 TLE 手术的 86 名患者中,有 26 名患者(30%)需要通过简单牵引移除 39 条导联。使用扫描电子显微镜进行的检查一致显示,所有导线的绝缘都受到了损坏。共发现 347 个受损部位:其中 261 个未出现导联脱封,86 个出现脱封。值得注意的是,位于口袋内区域的导线部分最容易受损(几率比(OR):=9.112,95% 置信区间(95% CI):3.326-24.960),而静脉内区域的易损性最低(OR:0.323,95% CI:0.151-0.694):我们的研究显示,所有接受评估的导联都表现出绝缘损坏,其中内袋区段的损坏率明显高于静脉内区段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endocardial lead insulation wear in a scanning and optical microscope.

Background: The path and interaction of leads within the cardiovascular system are influenced by various factors, including the implantation technique. Furthermore, the multifaceted composition of these leads, often comprising multiple materials, can contribute to their potential degradation and wear over time.

Objectives: Our aim was to investigate the wear of lead insulation following the removal of transvenous leads and pinpoint the regions of the lead most vulnerable to damage.

Material and methods: We undertook a prospective analysis of patients from a single tertiary center who underwent transvenous lead explantation (TLE) between October 1, 2013, and July 31, 2015. Specifically, our examination focused on endocardial leads removed using simple screw-out and gentle traction techniques. Subsequent lead evaluations were conducted utilizing scanning electron and optical microscopes.

Results: Among the 86 patients who underwent the TLE procedure, 26 patients (30%) required the removal of 39 leads through simple traction. Inspection using scanning electron microscopy consistently indicated insulation damage across all leads. A total of 347 damaged sites were identified: 261 without lead unsealing and 86 exhibiting unsealing. Notably, the sections of the leads located within the intra-pocket area demonstrated the highest vulnerability to damage (odds ratio (OR): = 9.112, 95% confidence interval (95% CI): 3.326-24.960), whereas the intravenous regions displayed the lowest susceptibility (OR: 0.323, 95% CI: 0.151-0.694).

Conclusions: Our study reveals that all evaluated leads exhibited insulation damage, with the intra-pocket segments manifesting a notably higher prevalence of damage than the intravenous segments.

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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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