title: Lead extraction: a new effective tool to overcome fibrous binding sites.
abstract: We report the case of a 50 year-old woman referred for extraction of an infected biventricular implantable cardioverter defibrillator (ICD) who underwent device and leads extraction. Due to adhesions at the level of the subclavian-innominate vein angle, manual traction with locking stylet was ineffective. A new mechanical sheath provided with a stainless steel bladed tip, the Evolution Mechanical Dilator Sheath (Cook Medical), was successfully used to complete lead extraction. As far as we know, this is the first report on the use of this new tool; its safety should be ascertained by increasing the number of cases but its simple use and its low cost make the Evolution Mechanical Dilator Sheath a new interesting tool that can be added to the instruments available for lead extraction.
authors.affiliation: Cardiac Arrhythmia and Heart Failure Research Center, Catholic University of Sacred Heart - St. Camillo-Forlanini Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Roberto
authors.initials: R
authors.lastname: Biddau
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Frontera
authors.forename: Antonella
authors.initials: A
authors.lastname: Camporeale
authors.forename: Caterina
authors.initials: C
authors.lastname: Bisceglia
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Forleo
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.forename: Paolo
authors.initials: P
authors.lastname: Zecchi
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000601:surgery; D006352:Heart Ventricles / Q000473:pathology* / Q000601:surgery*; D006801:Humans