Combined Percutaneous Mechanical Aspiration and Transvenous Lead Extraction in CIED-Related Endocarditis: A Case Report.

INTRODUCTION

Current guidelines recommend complete removal of a cardiac implantable electronic device (CIED) in infective endocarditis (IE), with surgical extraction indicated for large vegetations (> 20-25 mm).

CASE: We report a 68-year-old patient with CIED-related IE and a 3 × 3.5 cm lead vegetation successfully treated by percutaneous mechanical aspiration (PMA) using the FlowTriever system, followed by transvenous lead extraction (TLE). The combined approach achieved complete removal without complications or recurrence.

CONCLUSION

This case highlights PMA as a feasible, less invasive alternative to surgery in selected high-risk patients, enabling safe TLE by reducing vegetation size and embolic risk.