Key result
Cowboy Bridge technique enables lead extraction and implantation in venous stenosis by maintaining continuous access.
Why the study?
Maintaining continuous access to the right heart chambers during lead extraction is essential, especially when venous stenosis is present.
The Cowboy Bridge technique offers a feasible and reproducible strategy using retrograde snaring to maintain venous access during lead extractions in patients with severe venous stenosis requiring device upgrades.
May aid reimplantation after lead extraction in venous stenosis; extends options but leaves open broader applicability.
Maintaining continuous access to the right heart chambers during lead extraction is essential, especially when venous stenosis is present. The Cowboy Bridge technique is a novel and reproducible approach that implies retrograde snaring from a femoral access. We report our results applying this technique in two patients with venous stenosis who required a device upgrade with lead extraction. This procedure facilitates the implantation of new leads by maintaining thorough-and-through access and lowering the risk of perforation compared to anterograde or retrograde attempts to traverse the stenotic site with additional wires or catheters.
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Villegas et al. (2026) studied this question. The Cowboy Bridge technique enabled successful lead extraction and new lead implantation in two patients with venous stenosis by maintaining continuous access with reduced perforation risk.
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