Key result
Management of cardiac implantable electronic device infections with large lead vegetations remains challenging due to the risk of pulmonary embolism during percutaneous extraction.
Simultaneous lead extraction and vacuum-assisted vegetation removal is proposed as a technique for managing CIED infections with large vegetations.
Simultaneous extraction with vacuum-assisted removal merits prospective evaluation; hypothesis-generating and should not yet change practice in CIED infections.
The incidence of infection associated with cardiac implantable electronic devices (CIEDs) is rising at a rate faster than that of the number of implants.1 CIED infections typically require complete device and lead removal. The prevalence of vegetations is high in patients with infective indications who are referred for lead extraction.2 Because of the risk of hemodynamically significant pulmonary embolism associated with percutaneous lead extraction techniques, management of those with large lead vegetations continues to be challenging.
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Issa et al. (2015) studied Cardiac implantable electronic device (CIED) infections with large lead vegetations. Simultaneous lead extraction and vacuum-assisted vegetation removal was evaluated. Management of cardiac implantable electronic device infections with large lead vegetations remains challenging due to the risk of pulmonary embolism during percutaneous extraction.
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