title: Percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.
abstract: BACKGROUND
  Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.
  
  
  METHODS
  Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA) and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany).
  
  
  RESULTS
  Lead extraction was attempted in 59 leads from 36 patients (27 men), mean ± SD age 61 ± 5 years, with permanent pacemaker (n = 25), defibrillator (n = 8), or cardiac resynchronisation therapy (n = 3) with a mean ± SD implant duration of 50 ± 23 months. The indications for lead removal included pocket infection (n = 23), endocarditis (n = 2), and ventricular (n = 10) and atrial lead dysfunction (n = 1). Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4 ± 2 minutes/lead for leads implanted <48 months (n = 38) and 7 ± 3 minutes/lead for leads implanted >48 months (n = 21), P = 0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%.
  
  
  CONCLUSIONS
  In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Stylianos
authors: S
authors: Paraskevaidis
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Dimitrios
authors: 0000-0002-6882-0510
authors: D
authors: Konstantinou
authors: Third Department of Cardiology, Hippokrateion University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors: Vassilios
authors: 0000-0002-6982-4425
authors: V
authors: Vassilikos
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Efstratios
authors: 0000-0001-8282-2136
authors: E
authors: Theofilogiannakos
authors: Department of Cardiology, Electrophysiology Unit, Royal Brompton Hospital, London, UK.
authors: Lilian
authors: L
authors: Mantziari
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Athanasia
authors: A
authors: Megarisiotou
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Ioannis
authors: 0000-0002-6312-2131
authors: I
authors: Galitsianos
authors: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, 1 St. Kyriakidi Street, 54636 Thessaloniki, Greece.
authors: Charalambos
authors: C
authors: Karvounis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047548:Defibrillators; D020878:Device Removal; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial