Linked Life Data

11484752

Source:http://linkedlifedata.com/resource/pubmed/id/11484752

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2001-8-3
pubmed:abstractText
Pacing and defibrillation leads may need to be removed for several reasons including infection, interference with others leads, lack of vascular access or redundancy. However, the removal of chronically implanted leads is a major technical challenge because of the extensive adhesions that develop along the course of the leads over time. The techniques to remove chronic leads have been greatly facilitated by the development of an excimer laser sheath. We undertook an analysis of our experience with laser extraction in the first 50 leads attempted. An excimer laser sheath system, developed by the Spectranetics Corporation, was used to extract 50 chronically implanted leads in 34 patients. The mean patient age was 64+/-12 years, all were male and the average duration that the leads had been implanted was 5.0+/-3.9 years. Two-thirds of the leads were pacemaker and one-third were defibrillator leads. There was a 100% clinical success rate and 48 of the 50 leads were completely removed. There were no major complications. There was one minor complication of subclavian vein thrombosis and two haemodynamically non-significant episodes of air embolism. The main limitation observed was failure of the excimer laser sheath to advance in 18% of cases, probably due to the presence of calcified adherences on leads. Two strategies were found useful to deal with this problem: under the clavicle stainless-steel sheaths were used to break up calcified adherences and within the venous system the laser sheath was upsized in order to advance over the calcification on the lead. It was concluded that excimer laser has greatly facilitated the removal of chronically implanted pacemaker and defibrillator leads. There is a high success rate and low complication rate in our experience. The main limitation of laser is the presence of calcified adherences.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0268-8921
pubmed:author
pubmed:issnType
Print
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
113-21
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
2001
pubmed:articleTitle
Excimer laser for pacemaker and defibrillator lead extraction: techniques and clinical results.
pubmed:affiliation
Department of Internal Medicine, Hunter Holmes McGuire Veterans Affairs Medical Center and Medical College of Virginia/Virginia Commonwealth University, Richmond 23249, USA. david.gilligan@med.va.gov
pubmed:publicationType
Journal Article