Active-fixation coronary sinus pacing lead extraction: A hybrid approach

Starfix lead extraction: Clinical experience and technical issues

“…Such a mechanism may be responsible for acute failures in extracting leads, while chronic venous occlusion, due to reduction and slowing of blood flow with consequent thrombosis, may collaborate with worsening effect. The success rate for Starfix TLE is approximately 73%, clearly below the 96-98% reported rate for intracardiac conventional and passive fixation CS leads [1,2,[6][7][8][9][10][11][12]. Recent experience in implantation and extraction of Starfix leads is growing worldwide [13,14].…”

“…The bevel of the dilators could reach the main CS in 15 out of 19 patients, where information could have been gained, and a CS branch only in 7. Undeployment of fixation lobes was frequently prevented [2,[7][8][9][10], often occurring only with proximal ones [6][7][8][9]. Such a mechanism may be responsible for acute failures in extracting leads, while chronic venous occlusion, due to reduction and slowing of blood flow with consequent thrombosis, may collaborate with worsening effect.…”

“…Our surgeons refused elective surgical removal of the tip, because of its risky location, of the redo procedure, and of high surgical risk for the patient; for the same reasons, a surgical emergency procedure would have been prohibitive. In other cases, failure of transvenous extraction of the Starfix lead was treated by urgent surgical intervention [9].…”

Transvenous Lead Extractions: Current Approaches and Future Trends

“…Recently, minimally invasive approaches have been introduced that provide an alternative to median sternotomy. [48][49][50][51][52][53]…”

Intravascular Lead Extractions: Tips and Tricks

“…It appears that CS leads implanted for <2 years are amenable to manual traction [68] and even extraction of active fixation CS leads has been reported due to prolonged manual traction alone or careful use of a laser sheath within the CS. [69], [70], [71]. All the previously mentioned techniques have been successfully used for the removal of CS infected or malfunctioning leads.…”