title: The effectiveness of transvenous leads extractions implanted more than 10 years before.
abstract: BACKGROUND
  The increasing number of patients with cardiac implantable electronic devices (CIEDs) causes a rise in the absolute percentage of individuals qualifying for a transvenous lead extraction (TLE) due to infectious, vascular or lead failure related indications. As the survival time prolongs, TLE procedures more and more often concern the electrodes of long- -term functioning. Authors provide a retrospective analysis of the effectiveness and safety of TLE performed on leads implanted at least 10 years before the extraction.
  
  
  METHODS
  Between 2008 and 2012 we performed TLE of 364 electrodes in 217 patients. Out of these, 66 (18.1%) leads in 43 (19.8%) patients had been implanted for at least 10 years. The mean dwelling time for electrodes was 161 months (120 to 330). In 62% of cases CIED-related infection was an indication for TLE. The following extracting techniques were used: manual direct traction, device traction, mechanical telescopic sheaths, autorotational cutting sheaths and femoral approach.
  
  
  RESULTS
  Fifty-eight pacemakers and 8 defibrillating leads were extracted. Sixty-three (95%) completely, in the remaining 3 cases the clinical success was achieved with the small portion of the lead left into the vascular space. No major procedure complications were observed; minor complications were found in 3 (6%) patients.
  
  
  CONCLUSIONS
  TLE with the use of various endovascular techniques is an effective and safe method for treating infectious, vascular and mechanical complications of long-lasting CIEDs therapy.
authors.affiliation: 2nd Coronary Disease Depar tment, Institute of Car diology, Warsaw, Poland. maciag_o@poczta.onet.pl.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Maciąg
authors.forename: Paweł
authors.initials: P
authors.lastname: Syska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Przybylski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kuśmierski
authors.forename: Maciej
authors.initials: M
authors.lastname: Sterliński
authors.forename: Artur
authors.initials: A
authors.lastname: Oręziak
authors.forename: Mariusz
authors.initials: M
authors.lastname: Pytkowski
authors.forename: Jacek
authors.initials: J
authors.lastname: Różański
authors.forename: Hanna
authors.initials: H
authors.lastname: Szwed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D004866:Equipment Contamination; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult