title: Intravascular lead extraction using the excimer laser: pitfalls and tips for success.
abstract: Removal of retained pacemaker and defibrillator leads is often indicated in the face of infection, venous obstruction, or lead malfunction with the need to upgrade to a newer lead. While simple traction is often successful in newly placed or infected leads, chronic leads can be problematic in their removal. The laser extraction sheath offers a method for removal by "cutting" through scar tissue. This device can be potentially hazardous, so the laser lead extraction procedures should be performed in a properly equipped operating room for immediate cardiothoracic surgical intervention should massive bleeding occur. This article outlines a few suggestions for avoiding severe complications with this useful procedure.
authors.affiliation: Department of Surgery, Texas A&M Health Science Center College of Medicine, and Division of Vascular Surgery, Scott and White Memorial Hospital, Temple, TX 76508, USA. rfeldtman@swmail.sw.org
authors.forename: Robert W
authors.initials: RW
authors.lastname: Feldtman
mesh_terms: D017546:Angioscopy / Q000379:methods*; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000379:methods*; D004567:Electrodes, Implanted; D004868:Equipment Failure; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D010138:Pacemaker, Artificial; D017410:Practice Guidelines as Topic