title: Transvenous removal of cardiac implantable electronic device leads.
abstract: OBJECTIVE
  The number and complexity of cardiac implantable electronic devices (CIEDs) have increased, as has the number of related complications, often leading to removal of the implanted system. The aim of this study was to characterize transvenous explantation/extraction of CIED leads in a reference center.
  
  
  METHODS
  This was a descriptive observational study of patients consecutively admitted from January 2009 to May 2014 for transvenous lead extraction.
  
  
  RESULTS
  The sample consisted of 109 patients, with a mean age of 64.6±16.62 years, 73.1% male. The main indication for lead extraction was CIED infection. The mean time from first implantation to lead removal was 5.6±4.89 years. Blood cultures were positive in 32.8% of cases and 29% of patients had vegetations on echocardiography. A total of 228 cardiac leads were removed, of which 58.8% were ventricular, 32.4% atrial and 8.8% coronary sinus. Complete clinical success was achieved in 97.2% of cases, while procedural success was complete in 93.4% and partial in 5.3%. The complications reported were three cases of significant pocket hematoma, one of subclavian vein thrombosis and three of cardiac tamponade, effectively treated by pericardiocentesis.
  
  
  CONCLUSIONS
  Transvenous explantion or extraction of CIED leads was highly effective. A high level of experience is an essential factor in the success and safety of the procedure.
authors.affiliation: Serviço de Cardiologia, Hospital de Guimarães, Guimarães, Portugal. Electronic address: silviamartinsribeiro@gmail.com.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Ribeiro
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Leite
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Oliveira
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Pereira
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Pinheiro
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Ermida
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Natália
authors.initials: N
authors.lastname: António
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ventura
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Cristóvão
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Elvas
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Providência
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D020878:Device Removal; D005260:Female; D006321:Heart; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial
keywords: Cardiac resynchronization therapy; Cardioversor desfibrilhador implantável; Extração de eletrocateteres; Implantable cardioverter‐defibrillator; Infection; Infeção; Lead extraction; Pacemaker; Terapia de ressincronização cardíaca