INTRODUCTION
In parallel to the increased use of cardiac implantable electronic
devices (CIED), the electrophysiology society faced with device-related
problems like device upgrade, device-related infection, electrode
dysfunction, and dislodgement which should be managed with effective and
reliable methods 1. Despite significant improvement
over the last decade in transvenous lead extraction (TLE) technology,
the procedure is still associated with a significant morbidity and
mortality 2.
After implantation, transvenous leads are often encapsulated with
fibrotic capsules which adheres to vascular and intra-cardiac tissue by
different humoral and cellular mechanisms 1. Among
various tools and methods, powered extraction devices are required in
the removal of the chronically implanted leads 3.
Rotational mechanical dilator sheaths are acting by dissection of the
fibrotic tissue in which the electrodes connected using the threaded end
portion of the system 4. Currently, two different
mechanical dilator sheaths with variable technical properties were
available in the market [Evolution® (Cook Medical,
Bloomington, IN, USA) and TightRailTM (Spectranetics
Corp., Colorado Springs, Colorado, USA) mechanical dilator sheaths].
Both TLE system revealed high efficacy rates and acceptable safety
results 3,5. However, the comparative data are scarce
among different types of powered extraction tools. Previous studies have
presented the data of single TLE device in general5,6. There is only one small study regarding the
comparison of different rotational mechanical dilators7.
Thus, we aimed to compare the safety and efficacy outcomes, and
all-cause mortality at long-term follow-up in a large-scale study
population who underwent TLE using two different rotational mechanical
dilators sheaths.