Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Excimer laser for pacemaker and defibrillator lead extraction: Techniques and clinical results
Autore:
Gilligan, DM; Dan, D;
Indirizzi:
Hunter Holmes McGuire VA Med Ctr, Dept Internal Med, Div Cardiol, Cardiac Electrophysiol Lab, Richmond, VA 23249 USA Hunter Holmes McGuire VA Med Ctr Richmond VA USA 23249 mond, VA 23249 USA Virginia Commonwealth Univ, Med Coll Virginia, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA
Titolo Testata:
LASERS IN MEDICAL SCIENCE
fascicolo: 2, volume: 16, anno: 2001,
pagine: 113 - 121
SICI:
0268-8921(2001)16:2<113:ELFPAD>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERMANENT PACEMAKER; INITIAL EXPERIENCE; INTRAVASCULAR EXTRACTION; TRANSVENOUS PACEMAKER; LOCKING STYLETS; PACING LEADS; SHEATH; MULTICENTER; EFFICACY;
Keywords:
defibrillator; electrophysiology; excimer; laser; lead extraction; pacemaker; ultraviolet;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Gilligan, DM Hunter Holmes McGuire VA Med Ctr, Dept Internal Med, Div Cardiol, Cardiac Electrophysiol Lab, 1201 Broad Rock Blvd 111J3, Richmond, VA 23249 USA Hunter Holmes McGuire VA Med Ctr 1201 Broad Rock Blvd 111J3 Richmond VA USA 23249
Citazione:
D.M. Gilligan e D. Dan, "Excimer laser for pacemaker and defibrillator lead extraction: Techniques and clinical results", LASER MED S, 16(2), 2001, pp. 113-121

Abstract

Pacing and defibrillation leads may need to be removed for several reasonsincluding infection, interference with others leads, lack of vascular access or redundancy. However, the removal of chronically implanted leads is a major technical challenge because of the extensive adhesions that develop along the course of the leads over time. The techniques to remove chronic leads have been greatly facilitated by the development of an excimer laser sheath. We undertook an analysis of our experience with laser extraction in the first 50 leads attempted. An excimer laser sheath system, developed by the Spectranetics Corporation, was used to extract 50 chronically implanted leads in 34 patients. The mean patient age was 64 +/- 12 years, all were male and the average duration that the leads had been implanted was 5.0 +/- 3.9 years, Two-thirds of the leads were pacemaker and one-third were defibrillator leads. There was a 100% clinical success rate and 48 of the 50 leadswere completely removed. There were no major complications. There was one minor complication of subclavian vein thrombosis and two haemodynamically non-significant episodes of air embolism. The main limitation observed was failure of the excimer laser sheath to advance in 18% of cases, probably dueto the presence of calcified adherences on leads. Two strategies were found useful to deal with this problem: under the clavicle stainless-steel sheaths were used to break up calcified adherences and within the venous systemthe laser sheath was upsized in order to advance over the calcification onthe lead. It was concluded that excimer laser has greatly facilitated the removal of chronically implanted pacemaker and defibrillator leads. There is a high success rate and low complication rate in our experience. The mainlimitation of laser is the presence of calcified adherences.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 03:53:42