title: Transvenous extraction of cardiac rhythm device leads: a report of the experience from a single referral centre in Greece.
abstract: BACKGROUND
  As rates of implanted cardiac electronic devices continue to rise, lead extraction procedures are crucial for the management of complications. The optimal method for such procedures has been constantly debated. We sought to review our experience of lead extraction using a conventional technique.
  
  
  METHODS
  This was a retrospective study of lead extraction procedures in a major referral centre in Greece. Leads were extracted in a series of 66 consecutive patients (69% men, age range 53-90 years) who visited our centre between August 2008 and June 2012. The extraction procedure was performed in the catheterization lab with a widely used system composed of a locking stylet and sheath.
  
  
  RESULTS
  A total of 120 leads were extracted (51 atrial, 69 ventricular) including 19 defibrillator leads and 9 coronary sinus leads. The most frequent indication for lead extraction was infective endocarditis (28 patients, 42%), followed by generator pocket infection (22 patients, 33%), and lead malfunction (16 patients, 24%). Extraction was achieved through the venous entry-site approach in all procedures. The leads were completely extracted in 65 patients (98.5%). Only one complication was recorded: perforation of the right atrium in one patient (1.5%), who eventually underwent emergency cardiac surgery with a good outcome.
  
  
  CONCLUSIONS
  Our data confirm that a conventional mechanical technique is highly effective for successful extraction of all types of implanted cardiac electronic device leads and is associated with very limited complications.
authors.affiliation: State Cardiology Division, Hippokration Hospital, Athens, Greece.
authors.forename: Skevos
authors.initials: S
authors.lastname: Sideris
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kasiakogias
authors.forename: Maria
authors.initials: M
authors.lastname: Pirounaki
authors.forename: Kostas
authors.initials: K
authors.lastname: Gatzoulis
authors.forename: Ilias
authors.initials: I
authors.lastname: Sotiropoulos
authors.forename: Polichronis
authors.initials: P
authors.lastname: Dilaveris
authors.forename: Kostas
authors.initials: K
authors.lastname: Traxanas
authors.forename: Apostolos-Ilias
authors.initials: AI
authors.lastname: Vouliotis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Voliotis
authors.forename: Kostas
authors.initials: K
authors.lastname: Manakos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Konstantinidis
authors.forename: George
authors.initials: G
authors.lastname: Trantalis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Lymperiadis
authors.forename: George
authors.initials: G
authors.lastname: Stavropoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kallikazaros
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D017147:Defibrillators, Implantable / Q000009:adverse effects; D020878:Device Removal / Q000009:adverse effects / Q000379:methods; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004696:Endocarditis / Q000209:etiology / Q000601:surgery; D004868:Equipment Failure; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010138:Pacemaker, Artificial / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies