Key result
Femoral approach with a modified working station successfully extracts a displaced 9-year-old lead.
Case Report (n=1)
This case demonstrates a successful femoral approach for extracting a seemingly inaccessible, abandoned lead with a frayed proximal ending, highlighting the need for longer Byrd dilators designed for femoral use.
May enable femoral extraction of select abandoned leads; hypothesis-generating and should not yet change practice.
In this study, we present the case of the extraction of a non-functioning, abandoned, chronically implanted nine year-old lead with proximal extended frayed ending, displaced spontaneously into the subclavian vein. The seemingly inaccessible lead was extracted from the body using the femoral approach. The lead was looped with a pig-tail catheter, standard guide-wire, and basket Dotter catheter, and the proximal ingrown ending was liberated. Finally, it was grasped with a basket catheter and its tip was liberated using oblique cut rotated internal sheath of a Femoral Working Station: using it as a Byrd dilator designed for subclavian approach. An additional difficulty was the risk of dislodging the correct endocardial lead in the pacemaker-dependent patient. The procedure indicates the necessity for the production of longer Byrd dilators designed for the femoral approach.
No takes yet. Share an insight, caveat, or question.
Kutarski et al. (2012) conducted a case report in Abandoned, displaced pacemaker lead (n=1). Femoral approach lead extraction was evaluated. An abandoned, displaced 9-year-old lead was successfully extracted using a femoral approach with a pig-tail catheter, basket catheter, and modified Femoral Working Station.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: