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学科主题: 临床医学
题名:
Implantable defibrillator lead extraction with optimized standard extraction techniques
作者: Chu, Xian-Ming1,2; Li, Xue-Bin1; Zhang, Ping1; An, Yi2; Duan, Jiang-Bo1; Wang, Long1; Li, Ding1; Li, Bing3; Guo, Ji-Hong1
关键词: Lead ; Extraction ; Implantable cardioverter-defibrillator ; Infection ; Complications
刊名: JOURNAL OF GERIATRIC CARDIOLOGY
发表日期: 2013
DOI: 10.3724/SP.J.1263.2012.08211
卷: 10, 期:1, 页:3-9
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems ; Geriatrics & Gerontology
研究领域[WOS]: Cardiovascular System & Cardiology ; Geriatrics & Gerontology
关键词[WOS]: ELECTRONIC DEVICE INFECTIONS ; PACEMAKER ; MANAGEMENT ; DIAGNOSIS ; MORTALITY ; REMOVAL ; SYSTEMS
英文摘要:

Background Implantable cardioverter-defibrillator (ICD) leads might not be extracted especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate transvenous extraction of ICD leads using optimized standard techniques. Methods We prospectively analyzed clinical characteristics, optimized extraction techniques and the feasibility of extraction for 40 patients (33 males; mean age 47.9 +/- 16.1 years) with 42 ICD leads. Results Complete procedural success rate was 95.2% (40/42), and the clinical success rate was 97.6% (41/42). One ICD lead required cardiothoracic surgery. Minor complications occurred in three cases (7.5%), and no major complications or death occurred. Locking stylets were used to extract most leads (34, 81.0%) and almost half of the leads (20, 47.6%) required mechanical dilatation to free fibrotic adhesions; these leads had been implanted for a longer period of time than the others (43.7 +/- 18.2 vs. 18.4 +/- 13.4 months, P < 0.05). Three-quarters of the leads (30, 71.4%) were extracted with locking stylets plus manual traction (12, 28.6%), or mechanical dilatation with counter-traction (18, 42.8%) by the superior vena cava approach and one-quarter of the leads (11, 26.2%) were removed by optimized snare techniques using the femoral vein approach. Median extraction time was 20 min (range 2-68 min) per lead. Linear regression analysis showed that the extraction time was significantly correlated with implant duration (r = 0.70, P < 0.001). Median follow-up was 14.5 months (range 1-58 months), no infection, or procedure-related death occurred in our series. Conclusions Our optimized procedure for transvenous extraction of ICD leads provides a practical and low-cost method for standard procedures. J Geriatr Cardiol 2013; 10: 3-9. doi: 10.3724/SP.J.1263.2012.08211

语种: 英语
所属项目编号: 81001346 ; 81071246 ; 2012YD18035 ; Z121107001012016
项目资助者: National Natural Science Foundation of China ; Shandong Project ; Capital Project
WOS记录号: WOS:000316871000001
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59555
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Dept Cardiac Electrophysiol, Beijing 100044, Peoples R China
2.Qingdao Univ, Coll Med, Affiliated Hosp, Dept Cardiol, Qingdao 266100, Peoples R China
3.Qingdao Univ, Coll Med, Dept Biol, Qingdao 266021, Peoples R China

Recommended Citation:
Chu, Xian-Ming,Li, Xue-Bin,Zhang, Ping,et al. Implantable defibrillator lead extraction with optimized standard extraction techniques[J]. JOURNAL OF GERIATRIC CARDIOLOGY,2013,10(1):3-9.
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