Laser-assisted extraction of a pacing lead with a supraclavicular course.
Ontology highlight
ABSTRACT:
SUBMITTER: Morin DP
PROVIDER: S-EPMC5418612 | biostudies-literature | 2015 May
REPOSITORIES: biostudies-literature
Publications
Laser-assisted extraction of a pacing lead with a supraclavicular course.
HeartRhythm case reports 20150421 3
Similar Datasets
Project description:BackgroundTransvenous laser lead extraction (TLE) for cardiac implantable electric devices (CIED) is a challenging procedure especially if performed in octogenarians. In this study we evaluated the safety and efficacy of transvenous laser lead extraction in elderly patients.MethodsThis is a retrospective study of octogenarian patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Philips, San Diego, USA). 270 Consecutive patients were included. Patients were divided into two groups. Octogenarian group and non-octogenarian group. The Data was gathered from patients treated between September 2013 and January 2020 and is retrospectively analyzed.ResultsOf 270 consecutive patients, 38 (14.0%) were 80 years old or more. The total number of the extracted leads was 556 among which 84(15.0%) from the Octogenarian group. From these leads were 155 single coil leads, 82 dual coil leads, 129 right ventricular pacing leads, 155 right atrial leads, and 35 left ventricular leads. In the Octogenarian group the number of removed leads was as follows: 13 single coil leads, 10 dual coil leads, 28 right ventricular pacing leads, 28 right atrial leads and 5 left ventricular leads. No mortality was recorded in the Octogenarian group. One patient in the YG suffered from a superior vena cava tear and one patient suffered from pulmonary embolism.ConclusionIn octogenarian laser assisted lead extraction patients is a safe and effective procedure. No increase in morbidity, mortality or perioperative complication could be recorded in this group. Age should not be a limiting factor to perform this procedure.
| S-EPMC10588874 | biostudies-literature
Project description:BackgroundPatients with a cardiac implantable electronic device (CIED)-induced tricuspid regurgitation (TR) have an increased mortality and morbidity. However, the impact of CIED-lead extraction and its indications are not well-defined.Case summaryA 69-year-old woman presented with recurrent hospital admissions for right heart failure refractory to medical therapy, on the background of a single-chamber permanent pacemaker (Biotronik) implanted 6 years ago for tachycardia-bradycardia syndrome. Transoesophageal echocardiography identified severe TR which was predominantly CIED-induced from a lead impingement of the posterior tricuspid valve (TV) leaflet preventing adequate leaflet coaptation. This had progressed to cause a degree of secondary functional TR. The patient underwent pacing lead extraction followed by epicardial lead placement via minithoracotomy, with significant symptomatic and echographic improvement of TR.DiscussionCIED-induced TR from a lead impingement of TV leaflets carries the highest risk of TR and its consequences. This case illustrates the significance of the relationship between CIED-leads and the TV, which impacts management strategy. We recommend a mechanistic approach and incorporating CIED-lead interaction with the TV apparatus as the underlying principle in developing future management guidelines for CIED-induced TR.
| S-EPMC9295692 | biostudies-literature
Project description: Not available
| S-EPMC5412662 | biostudies-literature
Project description:IntroductionThe provision of efficient dental care to patients with hemostatic disorders is tied to difficulties and problems, such as prolonged bleeding after or during surgical manipulation.Aimwas to increase the efficiency of oral surgery in patients with thrombocytopenia with the use of erbium laser on different stages of tooth extraction.MethodsPatients (n = 96) were selected for tooth extraction on an outpatient basis: patients with confirmed thrombocytopenia (age 44 ± 15.4, 19-74) were included in the 1st group, and patients without impaired hemostasis (age 47.6 ± 15.3, 19-81) were included in the 2nd group (p > 0.05). In the 1st group, operation with the use of erbium laser with with a wavelength of 2490 nm in a noncontact mode was performed in two stages: separation of a circular tooth ligament and curettage of the socket after tooth extraction. In the 2nd group (control), the treatment was provided according to a traditional algorithm. Before the operation, the lab blood tests for thrombocytes were performed in both groups; moreover, for the 1st group, the duration of bleeding and total coagulation were evaluated. In the postoperative period, pain and edema of soft tissues and hemostasis duration were assessed in both groups.ResultsAccording to the results of our research, the use of erbium laser in the 1st group allowed us to decrease hemostasis duration compared with the control group of patients (80.9 ± 35.9 and 175 ± 67.5 sec, p < 0.01) and reach the similar probability of postoperative bleeding after tooth extraction (p < 0.5). Pain and edema of soft tissues in dynamics after operation were less in the 1st group (p < 0.001).ConclusionApplication of erbium laser is an up-to-date method that can be successfully used in surgical treatment in patients with hemostasis failure for bleeding and other postoperative complications prevention and stimulation of the alveolar epithelialization after tooth extraction.
| S-EPMC8824248 | biostudies-literature
Project description:BackgroundPeri-procedural transoesophageal echocardiography (TOE) is important in monitoring and minimizing major complications during pacing lead extraction. It is a widely accepted precautionary measure, especially in extractions considered to be higher risk. Pacing lead extraction may be challenging, and it is associated with significant risk of major bleeding from vascular trauma.Case summaryWe present a case of an 87-year-old woman who had an extraction of a ventricular pacing lead that had perforated to an extra-cardiac location, most likely to the left pleural space. Peri-procedural TOE was used as a precaution. The entire pacing lead was successfully extracted with gentle traction using standard equipment (mechanical technique). Extraction was followed by development of pneumomediastinum and a left pleural effusion, initially attributed to pulmonary injury from the pacing lead but which proved to be related to oesophageal injury from the TOE.DiscussionTransoesophageal echocardiography-related complications are uncommon but should be considered in cases of unexpected post-procedural deterioration. Clinical deterioration after a seemingly uneventful procedure should prompt a thorough case review. A systematic approach should be applied to identify the offending cause and enable corrective measures to be undertaken. This case report is an important reminder to all operators utilizing TOE for peri-procedural purposes that this precautionary measure itself also independently exposes the patient to additional risk.
| S-EPMC6439371 | biostudies-literature
Project description:AimsTransvenous lead extraction (TLE) is performed using non-laser and laser techniques with overall high efficacy and safety. Variation in outcomes between the two approaches does exist with limited comparative evidence in the literature. We sought to compare non-laser and laser TLE in a meta-analysis.Methods and resultsWe searched Medline, Embase, Scopus, ClinicalTrials.gov, and CENTRAL databases for TLE studies published between 1991 and 2021. From the included 68 studies, safety and efficacy data were carefully evaluated and extracted. Aggregated cases of outcomes were used to calculate odds ratio (OR), and pooled rates were synthesized from eligible studies to compare non-laser and laser techniques. Subgroup comparison of rotational tool and laser extraction was also performed. Non-laser in comparison with laser had lower procedural mortality (pooled rate 0% vs. 0.1%, P < 0.01), major complications (pooled rate 0.7% vs. 1.7%, P < 0.01), and superior vena cava (SVC) injury (pooled rate 0% vs. 0.5%, P < 0.001), with higher complete success (pooled rate 96.5% vs. 93.8%, P < 0.01). Non-laser comparatively to laser was more likely to achieve clinical [OR 2.16 (1.77-2.63), P < 0.01] and complete [OR 1.87 (1.69-2.08), P < 0.01] success, with a lower procedural mortality risk [OR 1.6 (1.02-2.5), P < 0.05]. In the subgroup analysis, rotational tool compared with laser achieved greater complete success (pooled rate 97.4% vs. 95%, P < 0.01) with lower SVC injury (pooled rate 0% vs. 0.7%, P < 0.01).ConclusionNon-laser TLE is associated with a better safety and efficacy profile when compared with laser methods. There is a greater risk of SVC injury associated with laser sheath extraction.
| S-EPMC10638006 | biostudies-literature
Project description:BackgroundTemporary pacing is necessary in pacemaker-dependent patients after transvenous lead extraction (TLE) for cardiac implantable electronic device infection. In case of unavailability of other accesses, we propose to use the ipsilateral subclavian access (ISA) combined with a standard permanent active fixation lead for the temporary pacemaker and present preliminary data.MethodsWe consecutively enrolled patients undergoing TLE who received a temporary pacemaker using the ISA between August 2016 and April 2020 at our centre.ResultsDuring the observation period, 36 patients undergoing TLE for pocket infection (72.2%), endocarditis (25.0%) or other causes received a temporary pacemaker over the ISA. Their mean age was 77.0 ± 10.7 years, and 13.9% were female. Complete TLE was achieved in 94.4%. There were no major periprocedural complications. Intra-hospital mortality was 11.1%. Pocket revision was performed in 19.4%. During long-term follow-up (23 ± 13 months), 8.3% had a relapse of local pocket infection and 2.8% needed rehospitalization for reintervention.ConclusionsTemporary pacing using a standard permanent active fixation lead using the ISA is a convenient alternative to conventional venous accesses. However, risks of implanting a lead into a previously infected area have to be taken into account.
| S-EPMC8977584 | biostudies-literature
Project description:Transvenous laser-assisted lead extraction is successful, with a low procedural complication rate for a wide range of indications. Here, we report a case of right internal jugular triple-lumen central venous catheter fracture and subsequent embolism to the right pulmonary artery during laser lead extraction that was successfully retrieved with a gooseneck snare. (Level of Difficulty: Advanced.) Central Illustration
| S-EPMC9847237 | biostudies-literature
Project description:Superior vena cava (SVC) syndrome is an uncommon but serious complication associated with chronic transvenous implanted leads. In the recent past, open-heart surgery combining lead extraction and epicardial implant was usually performed to reduce syndrome recurrences. We describe the case of a 78-year-old man successfully treated by percutaneous lead extraction associated with venous balloon angioplasty and reimplantation of leadless pacemaker. <Learning objective: Chronic vascular complications following lead implantation usually require surgical treatment, due to the need for subsequent epicardial implantation. Percutaneous lead extraction along with leadless pacing allowed effective non-surgical management of chronic complications of transvenous pacing.>.
| S-EPMC6149588 | biostudies-literature
Project description:Laser-assisted microbial culturomics
| PRJEB75613 | ENA