The lead extractor's toolbox: a review of current endovascular pacemaker and ICD lead extraction techniques

Bracke, FA (2003) The lead extractor's toolbox: a review of current endovascular pacemaker and ICD lead extraction techniques. Indian Pacing and Electrophysiology Journal, 3 (3). pp. 101-108. ISSN 0972-6292

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Abstract

Recently introduced pacemaker leads float freely within the veins and myocardium. Later on, fibrous encapsulation of the lead develops 1. These adhesions not only occur at the lead tip but are commonly found anywhere along the whole length of the lead at sites where the lead is in contact with the vein or the myocardium 1,2,3,4. These adhesions hamper lead removal as tight scar tissue can withhold the leads during traction. This not only occurs at the level of the flings and tines of passive fixation leads but at any level of the lead body, especially at sites of unequal diameter for example electrodes and defibrillator coils. Further the lead tip is often larger than the lead body due to the fixation mechanism and adhering scar tissue and can become impacted on withdrawal in the narrow canal provided by the fibrous envelope.

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