ヒグチ　サトシ   HIGUCHI Satoshi   樋口　諭    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Utility of a multipurpose catheter for transvenous extraction of old broken leads: A novel technique for fragile leads.
掲載誌名	正式名：Heart rhythm 略　 称：Heart Rhythm ISSNコード：15563871/15475271
掲載区分	国外
巻・号・頁	20(7),pp.976-981
著者・共著者	Okada Ayako†, Higuchi Satoshi†, Shoda Morio, Tabata Hiroaki, Kataoka Shohe, Shoin Wataru, Kobayashi Hideki,, Okano Takahiro,, Yoshie Koji, Kato Ken,, Saigusa Tatsuya, Ebisawa Soichiro, Motoki Hirohiko, Kuwahara Koichiro
発行年月	2023/07
概要	BACKGROUND:Transvenous lead extraction has been possible since the 1980s. However, complications during lead extraction, such as the distal end fragment of the lead remaining in the myocardium or venous system and injury to the veins or heart, have been reported.OBJECTIVE:The purpose of this study was to examine our method for complete removal of a separated lead, as extraction of long-term implanted devices is difficult using standard methods and may require additional procedures. The removal of leads with inner conductor coil and lead tip separated from outer insulation, conductor coil, and proximal ring electrode using a multipurpose catheter is reported.METHODS:In total, 345 consecutive patients who underwent transvenous lead extraction (TLE) from April 2014 to March 2021 were retrospectively analyzed. Lead characteristics, device type, and indications for extraction were further analyzed in 20 patients who developed separation of the proximal ring electrode and outer conductor coil from the inner conductor and distal tip at the time of extraction.RESULTS:Extractions were performed using an excimer laser sheath laser and a Byrd polypropylene telescoping sheath (n = 15); laser, Byrd polypropylene telescoping sheath, and Evolution RL (n = 2); laser and Evolution RL (n = 3); Byrd polypropylene telescoping sheath and Evolution RL (n = 1); Byrd polypropylene telescoping sheath only (n = 4); and Evolution RL only (n = 2). Twenty-seven leads implanted for more than 10 years had lead separation. A multipurpose catheter was used to protect the fragile leads from further damage. All leads were completely extracted.CONCLUSION:All distal tip-to-proximal ring electrode separated leads were successfully removed using laser and other sheaths with the assistance of a multipurpose catheter, without any part of the leads remaining in the heart.
DOI	10.1016/j.hrthm.2023.03.209
PMID	37001747