Journal of cardiovascular electrophysiology · 2025
Management of Transvenous Leads in Patients With Iatrogenic Lead Perforation.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Younis Arwa, Awashra Ameer, Matteo Maria, Hussein Ayman A, Demian Joe, Santangeli Pasquale, Callahan Thomas, Martin David O, Mdaihly Mohamad, Nakhla Shady, Kanj Mohamed, Kochar Arshneel, Unai Shinya, Tong Michael Z, Sroubek Jakub, Saliba Walid I, Baranowski Bryan, Chung Mina K, Wazni Oussama M, Taigen Tyler
Аннотация
INTRODUCTION: Iatrogenic lead perforation is a rare but serious complication of cardiac implantable electronic device (CIED) implantation. Evidence on percutaneous management of subacute or delayed cases remains limited.
METHODS: We retrospectively reviewed 38 patients treated for iatrogenic lead perforation between January 2012 and October 2024. Acute lead perforation cases, which were managed during the implantation procedure, were excluded. Lead removal was performed under imaging guidance in either the electrophysiology (EP) lab or a hybrid operating room (OR) with surgical backup. Clinical presentation, imaging, procedural approach, and outcomes were analyzed.
RESULTS: Of 38 patients, 25 underwent lead removal in the EP lab and 13 in the OR. The mean age was 67 ± 15 years; 58% were female. Most perforated leads were pacemaker leads (58%), typically involving the right ventricle (72%). Complete removal and reimplantation were achieved in all patients using simple traction with or without a locking stylet. Pericardiocentesis was required in 8% of cases. No major complications or delayed events were observed over a median 16-month follow-up.
CONCLUSION: Percutaneous removal of perforated leads is feasible and safe in the EP lab when performed by experienced operators. Surgical backup should be readily available given the potential consequences of this complication.
METHODS: We retrospectively reviewed 38 patients treated for iatrogenic lead perforation between January 2012 and October 2024. Acute lead perforation cases, which were managed during the implantation procedure, were excluded. Lead removal was performed under imaging guidance in either the electrophysiology (EP) lab or a hybrid operating room (OR) with surgical backup. Clinical presentation, imaging, procedural approach, and outcomes were analyzed.
RESULTS: Of 38 patients, 25 underwent lead removal in the EP lab and 13 in the OR. The mean age was 67 ± 15 years; 58% were female. Most perforated leads were pacemaker leads (58%), typically involving the right ventricle (72%). Complete removal and reimplantation were achieved in all patients using simple traction with or without a locking stylet. Pericardiocentesis was required in 8% of cases. No major complications or delayed events were observed over a median 16-month follow-up.
CONCLUSION: Percutaneous removal of perforated leads is feasible and safe in the EP lab when performed by experienced operators. Surgical backup should be readily available given the potential consequences of this complication.