Lead Extraction of Very Old Leads—A GALLERY Subgroup Analysis

Background: Transvenous lead extraction using powered extraction sheaths is a well-established procedure. Lead dwell time has been described as a risk factor for procedure-related complications and extraction failure. We here investigated safety and efficacy of laser lead extraction in a GALLERY subgroup with leads implanted for ≥10 years.

Methods: A subgroup analysis of all patients (n = 857) with at least one lead aged ≥ 10 years from the German Laser Lead Extraction Registry (GALLERY) was performed. Primary extraction method was Laser lead extraction, with additional use of mechanical rotational sheaths or femoral snares, if necessary. Retrospective data analysis was performed.

Results: Mean patient’s age was 70.4 ± 13.7 years, 73.2% were male. 2107 leads were treated in 857 patients. The median lead dwell time of treated leads was 162 months (Range 120–457 months). Local- (40.1%) or systemic (30.1%) infection were the most frequent indications for lead extraction. Clinical success was achieved in 96.5%, while complete procedural success was 83.3%. Overall complication rate was 5.5%, including 3.2% major- and 2.3% minor complications. Procedure-related mortality was 0.6%, while overall in-hospital mortality was 3.6%.

Conclusion: In our study, transvenous lead extraction in leads aged ≥10 years, has shown reasonable success and complication rates with a low procedure related mortality. Therefore, increased lead age should not be a contraindication for lead extraction.

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Artikel online veröffentlicht:
13. Februar 2024