Key result
Preprocedural MDCT maps venous anatomy and lead course to guide CIED lead extraction.
Why the study?
Preprocedural imaging with multidetector computed tomography can evaluate lead course, central veins, and cardiac chambers to identify complications that may alter CIED lead extraction and reimplantation procedures.
Preprocedural MDCT provides critical anatomical information that can alter the approach to CIED lead extraction and subsequent reimplantation.
May inform CIED extraction planning; leaves open prospective outcome trials.
Cardiac implantable electronic devices (CIEDs) frequently need to be extracted due to infection, hardware failure, and other causes. The extraction of the CIED is typically performed using percutaneous methods. While these procedures are mostly performed without incident there is a small risk of significant complications. Dedicated imaging pre-CEID removal to include the central veins and heart with multidetector computed tomography (MDCT) can be utilized to evaluate the lead course and termination, the integrity of the central veins and cardiac chambers, and identify potential complications that may alter the lead extraction procedure as well as reimplantation of subsequent leads. Indications for preprocedural imaging, the technique of dedicated preprocedural lead extraction MDCT, and the approach to the interpretation of the images is discussed in this review.
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Lewis et al. (2020) conducted a review in Cardiac implantable electronic device (CIED) extraction. Preprocedural multidetector computed tomography (MDCT) was evaluated. Preprocedural multidetector computed tomography before CIED lead extraction evaluates lead course and venous integrity to identify potential complications and guide the extraction procedure.
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