Infectious complications in patients with devices: Lead extraction

Complications related to device implantation, such as infections and malfunction, play a major role when considering the increasing rate of implant procedures. It is widely accepted in the scientific literature that the most effective way to eradicate device-related infections or complications resulting from malfunctioning involves the complete removal of the pacing system. The techniques of transvenous lead extraction include manual traction, mechanical dilation, powered sheaths (excimer laser system) using the femoral, jugular/subclavian or hybrid approach. The possibility of using different approaches, even in combination, has broadened the therapeutic armamentarium, allowing to revise the indications for removal of the system. Further clinical studies relating, specifically, to the different extraction techniques may contribute to develop common protocols by also evaluating the cost-effectiveness of the methods available. © 2010 AIM Publishing Srl.