Why the study?
Does the extraction of excess or failed sterile PM-D leads have a favorable risk-benefit profile compared to abandoning these leads in patients with failed, sterile pacemaker and defibrillator leads?
Does the extraction of excess or failed sterile PM-D leads have a favorable risk-benefit profile compared to abandoning these leads in patients with failed, sterile pacemaker and defibrillator leads?
The article highlights the lack of randomized trial data to support the routine extraction of failed, sterile pacemaker and defibrillator leads over abandoning them.
Answers are grounded in this paper and cite their sources.
Abandoning failed sterile leads remains reasonable absent randomized data; leaves open whether extraction improves long-term outcomes.
Transvenous pacemaker and defibrillator (PM-D) lead failure is an important clinical problem. Lead extraction is routinely performed in patients with transvenous pacemaker and defibrillator (PM-D) infections. The management of sterile PM-D leads that have failed or are no longer required is less uniform. While extraction of excess or failed sterile PM-D leads is often advocated, the risk of lead extraction must be weighed against the risk of abandoning these leads. There are no randomized trials comparing lead extraction with abandoning sterile leads in this setting. What then are the data that are used to advocate the extraction of excess or failed, sterile chronically implanted PM-D leads, and are the data adequate to make this recommendation?
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Venkataraman et al. (2009) studied this question.
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