A new tool for transvenous pacing lead extraction

概要

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In recent years, the need for a lead-removal technique has increased. Various extraction devices for traction and dissection are used worldwide, and quite a few of these devices are available in Japan. This paper details our experience using a new tool for manual dissection during transvenous pacing lead extraction. Five leads from 4 patients were considered for extraction using a new tool, the Amplatz renal dilator (Cook Ireland Ltd., Limerick, Ireland). The dilator was advanced following the lead course, similar to the over-the-wire technique. From 2 (50%) of the patients, 2 leads were extracted successfully using this procedure. No complications occurred in any of the patients. The remaining 3 leads could not be removed due to 2 reasons: first, the lead was entrapped in the supra vena cava, and second, the new dissection tool could not be inserted into the implant vein because of the tight space under the clavicle. Although the Amplatz renal dilator was useful for dissection, it was not sufficient for achieving complete procedural success. Our experience suggests that the Amplatz renal dilator can be a feasible and safe option for low-risk manual dissection in transvenous pacing lead extraction.