Key result
Transvenous lead extraction achieves high procedural efficacy with ~1% to 2% major complication rates.
Why the study?
Rising cardiac implantable electronic device use and widening removal indications have increased transvenous lead extraction demand, which still carries risks of significant complications despite advancements.
Transvenous lead extraction has evolved with advanced methodologies improving safety and efficacy, though significant risks remain.
Cardiac implantable electronic devices are the cornerstone of cardiac rhythm management, with a significant number of implantations annually. A rising prevalence of cardiac implantable electronic devices coupled with widening indications for device removal has fuelled a demand for transvenous lead extraction (TLE). With advancement of tools and techniques, the safety and efficacy profile of TLE has significantly improved since its inception. Despite these advances, TLE continues to carry risk of significant complications, including a superior vena cava injury and mortality. However, innovative approaches to lead extraction, including the use of the jugular and femoral accesses, offers potential for further gains in safety and efficacy. In this review, the indications and risks of TLE are discussed while examining the evolution of this procedure from simple traction to advanced methodologies, which have contributed to a significant improvement in safety and efficacy.
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Akhtar et al. (2023) conducted a review in Cardiac implantable electronic device complications. Transvenous Lead Extraction (TLE) was evaluated. Transvenous lead extraction has evolved into a highly effective procedure with a low major complication rate (1-1.7%) driven by advancements in powered sheaths and multi-access techniques.
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