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Tesi etd-11272019-181409


Thesis type
Tesi di specializzazione (5 anni)
Author
GIANNOTTI SANTORO, MARIO
URN
etd-11272019-181409
Title
Procedural outcomes associated with transvenous lead extraction in patients with abandoned leads
Struttura
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Corso di studi
MALATTIE DELL'APPARATO CARDIOVASCOLARE
Supervisors
relatore Prof. Pedrinelli, Roberto
relatore Prof.ssa Bongiorni, Maria Grazia
Parole chiave
  • ICD
  • extraction
  • arrhythmology
  • pacemaker
Data inizio appello
18/12/2019;
Consultabilità
Secretata d'ufficio
Data di rilascio
18/12/2089
Riassunto analitico
Background. The optimal management of redundant or malfunctioning leads is controversial. We aimed to assess the safety and efficacy of mechanical transvenous lead extraction (TLE) in patients with abandoned leads.
Methods. We analyzed consecutive TLE procedures performed in our center from January 2010 to December 2018. We evaluated the safety and efficacy of mechanical TLE in patients with abandoned (group 1) compared to not-abandoned (group 2) leads.
Results. We analyzed 1210 consecutive patients that required transvenous removal of 2343 leads. Group 1 accounted for 250 patients (21%), with 617 abandoned leads (26%). The total number of leads (3.0 vs. 2.0) dwelling time of the oldest lead (108.00 months vs. 60.00 months) and infectious indications for TLE were higher in Group 1. Clinical success was achieved in 1168 patients (96.5%) with a lower rate in Group 1 (90.4% vs. 98.1%; P<0.001). Major complications occurred in only nine patients (0.7 %), without significant differences among the two groups. The presence of one or more abandoned leads (OR 3.47; 95% IC: 1.07-11.19; P=0.037) and the dwelling time of the oldest lead (OR 1.01 for a month; 95% IC: 1.01-1.02; P<0.001) were associated with a higher risk of clinical failure.
Conclusions. Transvenous Mechanical lead extraction is a safe procedure also in high-risk settings, as patients with abandoned leads. Success rate resulted in a bit lower, especially in the presence of abandoned leads with long implantation time.
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