Key result
Intravascular lithotripsy successfully facilitates extraction of a heavily calcified 30-year-old ICD lead.
Why the study?
Transvenous lead extraction of leads with long dwell times, severe adhesions, and dense calcifications carries increased difficulty and risks.
Case Report (n=1)
No
Intravascular lithotripsy combined with IVUS guidance is a feasible and safe adjunctive technique for modifying calcium during the extraction of heavily calcified, long-dwell-time ICD leads.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for IVL in calcified lead extraction; prospective studies needed before wider consideration.
Transvenous lead extraction is indicated in a variety of scenarios, with one of the strongest indications being implantable cardioverter-defibrillator (ICD) infection. Long dwell times, severe lead adhesions, and dense calcifications increase the difficulty and risks associated with transvenous lead extraction. Intravascular lithotripsy for heavily calcified leads may be used as an adjunctive technique for extraction of these high-complexity cases.1 We present a case successfully using intravascular lithotripsy for a heavily calcified 30-year-old ICD lead with intravascular ultrasound (IVUS) showing fracture of intravascular calcium post lithotripsy therapy.
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Lutz et al. (2024) conducted a case report in Implantable cardioverter-defibrillator (ICD) pocket infection with heavily calcified lead (n=1). Intravascular lithotripsy and intravascular ultrasound (IVUS) was evaluated on Successful lead extraction. Intravascular lithotripsy successfully facilitated the safe extraction of a heavily calcified 30-year-old ICD lead, with intravascular ultrasound confirming fracture of the intravascular calcium.
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