Christoph T Starck1, Jan Steffel2, Etem Caliskan3, Tomas Holubec3, Felix Schoenrath4, Francesco Maisano3, Volkmar Falk4. 1. Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Augustenburger Platz 1, Berlin 13353, Germany starck@dhzb.de ct.starck@me.com ct.starck@web.de. 2. Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland. 3. Clinic of Cardiac and Vascular Surgery, University Hospital Zurich, Zurich, Switzerland. 4. Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Augustenburger Platz 1, Berlin 13353, Germany.
Abstract
AIMS: We investigated the safety and efficacy of a new bidirectional rotational mechanical extraction sheath (Evolution RL, Cook Medical, USA). METHODS AND RESULTS: From April 2013 until September 2014, we performed lead extraction procedures in 71 patients with 112 leads scheduled for extraction. During this time period, we used the new Evolution RL rotational sheath in 40 patients on 52 leads (24 pacemaker leads and 28 implantable cardioverter-defibrillator leads) scheduled for extraction. The mean lead implant duration in these patients was 100.2 (22-271) months. Forty leads were right ventricular leads, 10 right atrial leads, and 2 coronary sinus leads. Clinical success among the leads approached with the Evolution RL device was 98.1%. Operative mortality was zero. Major complications did not occur. Four minor complications were encountered (all pocket haematomas). No device-related complications were noted. In cases with multiple leads in situ, no wrapping of companion leads was seen. The average number of extraction tools used per lead was 2.4 (2-4) in the Evolution RL cohort. CONCLUSION: Based on the presented results of our initial experience with the new bidirectional rotational mechanical extraction device, its use is safe and efficient with high success rates in long implanted leads. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: We investigated the safety and efficacy of a new bidirectional rotational mechanical extraction sheath (Evolution RL, Cook Medical, USA). METHODS AND RESULTS: From April 2013 until September 2014, we performed lead extraction procedures in 71 patients with 112 leads scheduled for extraction. During this time period, we used the new Evolution RL rotational sheath in 40 patients on 52 leads (24 pacemaker leads and 28 implantable cardioverter-defibrillator leads) scheduled for extraction. The mean lead implant duration in these patients was 100.2 (22-271) months. Forty leads were right ventricular leads, 10 right atrial leads, and 2 coronary sinus leads. Clinical success among the leads approached with the Evolution RL device was 98.1%. Operative mortality was zero. Major complications did not occur. Four minor complications were encountered (all pocket haematomas). No device-related complications were noted. In cases with multiple leads in situ, no wrapping of companion leads was seen. The average number of extraction tools used per lead was 2.4 (2-4) in the Evolution RL cohort. CONCLUSION: Based on the presented results of our initial experience with the new bidirectional rotational mechanical extraction device, its use is safe and efficient with high success rates in long implanted leads. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Christoph T Starck; Elkin Gonzalez; Omar Al-Razzo; Patrizio Mazzone; Peter-Paul Delnoy; Alexander Breitenstein; Jan Steffel; Jürgen Eulert-Grehn; Pia Lanmüller; Francesco Melillo; Alessandra Marzi; Manav Sohal; Giulia Domenichini; Mark M Gallagher Journal: Europace Date: 2020-07-01 Impact factor: 5.214