title: Compression coil provides increased lead control in extraction procedures.
abstract: OBJECTIVE
  We investigated a new lead extraction tool (Compression Coil; One-Tie, Cook Medical) in an experimental traction force study.
  
  
  RESULTS
  On 13 pacemaker leads (Setrox JS53, Biotronik) traction force testing was performed under different configurations. The leads were assigned to three groups: (i) traction force testing without central locking stylet support (n = 5), (ii) traction force testing with the use of a locking stylet (Liberator, Cook Medical) and a proximal ligation suture (n = 4), (iii) traction force testing with the use of a locking stylet and a compression coil (n = 4). The following parameters were obtained for all groups: stress-strain curves, maximal forces, elastic modulus, post-testing lead length and lead elongation. In Groups 2 and 3 retraction of the locking stylet within the lead was measured [lead tip-locking stylet distance (LTLSD)]. Maximal forces for the three groups were: (i) 28.3 ± 0.3 N; (ii) 30.6 ± 3.0 N; (iii) 31.6 ± 2.9 N (1 vs. 2, P = 0.13; 1 vs. 3, P = 0.04; 2 vs. 3, P = 0.65). Elastic modulus was (i) 22.8 ± 0.1 MPa; (ii) 2830.8 ± 351.1 MPa; (iii) 2447.0 ± 510.5 MPa (1 vs. 2, P < 0.01; 1 vs. 3, P < 0.01; 2 vs. 3, P = 0.26). Mean LTLSD in Group 2 was 19.8 ± 3.2 cm and was 13.8 ± 1.7 cm in Group 3 (P = 0.02). The ratio of LTLSD/post-testing lead length was 0.37 ± 0.03 for Group 2 and 0.24 ± 0.03 for Group 3 (P < 0.01).
  
  
  CONCLUSIONS
  The application of a compression coil leads to an increased lead control expressed by less retraction of the locking stylet within the lead. This enables improved central support of extraction sheaths in the case of challenging extraction procedures.
authors.affiliation: Clinic of Cardiac and Vascular Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland ct.starck@me.com.
authors.forename: Christoph T
authors.initials: CT
authors.lastname: Starck
authors.affiliation: Functional Materials Laboratory, Institute for Chemical and Bioengineering, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Stepuk
authors.affiliation: Clinic of Cardiac and Vascular Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
authors.forename: Tomas
authors.initials: T
authors.lastname: Holubec
authors.affiliation: Clinic of Cardiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Steffel
authors.affiliation: Functional Materials Laboratory, Institute for Chemical and Bioengineering, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
authors.forename: Jan Wendelin
authors.initials: JW
authors.lastname: Stark
authors.affiliation: Clinic of Cardiac and Vascular Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
mesh_terms: D020878:Device Removal / Q000295:instrumentation*; D004567:Electrodes, Implanted; D006801:Humans; D010138:Pacemaker, Artificial
keywords: Compression coil; ICD; Lead extraction; Pacemaker