Demonstrates a successful percutaneous technique using a pigtail catheter and wire loop to extract an infected screw-in pacemaker lead via the femoral vein, avoiding open heart surgery.
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May enable percutaneous extraction of infected leads; leaves open need for validation in larger cohorts.
A 71-year-old woman was admitted after partial removal of an infected pacemaker system. Septicemia and subclavian vein thrombosis were present. With combined use of a pigtail catheter and a wire loop originally developed for endoscopic polypectomy, the infected catheter was pulled into the inferior vena cava. Counterclockwise rotation of the pigtail catheter following its fixation to the electrode by the wire loop allowed removal of the tip of the endocardial screw-in electrode from the myocardium and its extraction. Open heart surgery was avoided and the source of chronic infection was removed.
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Maisch et al. (1985) studied this question.
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