Key result
Balloon angioplasty and endovascular techniques enable successful transvenous phrenic nerve stimulation lead exchange.
Why the study?
No information was published on how to explant or replace the leads of the novel remedē fully implantable transvenous phrenic nerve stimulation device.
Case Report (n=1)
Endovascular lead exchange may be feasible in select remedē cases; leaves open generalizability and durability before wider adoption.
The remedē system is a novel fully implantable transvenous phrenic nerve stimulation (TPNS) device developed to treat central sleep apnea. No information is published on how to explant or replace its leads. An eighty-one year-old had a fractured lead and we removed it over a wire. However, unbreachable resistances occurred with a new lead deployed over the enclosed wire and interventional endovascular techniques were performed to reimplant a new fully functioning system. This first report demonstrates TPNS lead exchange is possible but can be challenging. Interventional maneuvers and techniques, including balloon angioplasty, can facilitate this procedure.
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Gutleben et al. (2020) conducted a case report in Central sleep apnea with fractured transvenous phrenic nerve stimulation (remedē system) lead (n=1). Interventional endovascular exchange of transvenous phrenic nerve stimulation lead using balloon angioplasty was evaluated on Successful extraction and reimplantation of a fully functioning transvenous phrenic nerve stimulation system. Interventional endovascular techniques including balloon angioplasty successfully facilitated transvenous phrenic nerve stimulation lead exchange in an 81-year-old patient (n=1).
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