Key result
Femoral excimer laser extraction removes a migrated, fractured RV lead after a failed superior approach.
Case Report (n=1)
The femoral approach using a laser sheath can be an effective alternative for extracting migrated pacemaker/ICD leads when the conventional superior approach fails.
Answers are grounded in this paper and cite their sources.
May offer bailout for failed superior lead extractions; leaves open generalizability beyond single cases.
Despite the latest improvements in pacemaker/defibrillator lead extraction techniques, this procedure may be hindered by specific problems related to patient/lead characteristics. We report the case of a 67-year-old man with a single-chamber implantable defibrillator (ICD) with a malfunctioning right ventricular (RV) defibrillating lead, referred for lead extraction. During extraction of the defibrillating electrode, the added sensing/pacing RV lead suddenly manifested an inapparent fracture with migration within the superior vena cava. Lead extraction through a superior conventional and laser-assisted approach was ineffective. The use of the laser sheath through the femoral approach allowed complete removal of the migrated lead and reimplantation of a new ICD lead.
No takes yet. Share an insight, caveat, or question.
Diemberger et al. (2010) conducted a case report in Malfunctioning right ventricular defibrillating lead (n=1). Excimer laser lead extraction by femoral approach vs. Superior conventional and laser-assisted approach was evaluated on Complete removal of the migrated lead and reimplantation of a new ICD lead. Excimer laser lead extraction via a femoral approach allowed complete removal of a migrated, fractured right ventricular lead after a superior approach failed.
Synapse has enriched 10 related papers. Consider them for comparative context: