Mechanical power sheath recanalization mediated lead implantation in patients with venous occlusion: technique and results

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Delnoy P, Witte O, Smit J, Ramdat Misier A, Elvan A, Ghani A,  Adiyaman A.

EP Europace. 2017;19 (Suppl 3):iii385: P1758.


Background: Chronic venous occlusion hampers lead revisions and upgrades in patients with pacemaker and ICD systems. This can make cardiothoracic surgery or contra-lateral implantation of leads with tunneling necessary. A technique using venous recanalization may be a preferred alternative.

Purpose: To assess the efficacy and safety of this new technique.

Methods: From 2009-2016 all consecutive patients planned for lead re-implantation or upgrade with known chronic venous occlusion were studied. All patients underwent extraction of an existing malfunctional or functional ICD- or pacemaker lead with the Cook Evolution mechanical powersheath. By using the lumen of the sheath, endovascular access to the heart was obtained for new leads.

Results: Forty-one patients were included with a total of 105 leads (2.56 ±1.1 leads per patient).The indication for this procedure was replacement of...

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