Initial experience with the TightRail™ Rotating Mechanical Dilator Sheath for transvenous lead extraction

Aytemir, Kudret; Yorgun, Hikmet; Canpolat, Uğur; Şahiner, Levent; Kaya, Ergün Barış; Evranos, Banu; Özer, Necla

doi:10.1093/europace/euv245

Cited by 41 publications

(55 citation statements)

References 18 publications

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“…Only two single‐center experiences with the TightRail™ have been reported: Aytemir used it in 23 patients with a median time from implantation of 72 months; compared to this report, in our multicentric experience the mean lead age was higher; Sawhney described successful TLE with TightRail™ in 3 patients . Compared to these previous reports, in our multicentric experience the median lead age was higher, further confirming the possibility to use the TightRail™ also in long‐standing, chronically implanted leads.…”

Section: Discussionmentioning

confidence: 99%

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Mazzone

Melillo

Radinovic

et al. 2020

Journal of Arrhythmia

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Aim The aim of this study is to assess the safety and efficacy of the new bidirectional rotational mechanical sheath TightRail™ (Spectranetics) for lead extraction. Methods and results This is a bicentric prospective study that included patients who underwent a transvenous lead extraction (TLE) in two Italian centers (San Raffaele Hospital and Humanitas Gavazzeni Hospital). From November 2016 to December 2018, 26 patients underwent a TLE procedure in which the TightRail™ was used. The new TightRail Sub‐C was used in 20 (76%) patients to overcome the fibrosis between the vessel and the first rib. Median age was 69 (IQR 60.7‐79.5) years. The indication for TLE were infection (57.7%) or lead dysfunction (42.3%). A total of 57 leads (range 1‐4), 40 of which using the TightRail (range 1‐4), were extracted. Overall mean implant duration was 98.2.0 ± 66.5 months. Mean age of the lead extracted with the TightRail sheath was 99.1 ± 70.2 months and was higher compared to that of the leads extracted manually (84.4 ± 60.3 months, P = .001). The overall clinical success was 100% and complete procedural success without the use of a snare was achieved in 98.3%. There were no cases of death or major complications and only two minor complications occurred. All patients were event‐free at 6‐month follow‐up. Conclusion This initial experience using the TightRail™ suggests a high safety and efficacy profile for extractions in a wide range of lead age.

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Section: Discussionmentioning

confidence: 99%

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Mazzone

Melillo

Radinovic

et al. 2020

Journal of Arrhythmia

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“…Previous studies with rotational mechanical dilator sheaths have demonstrated high success with low complication rates in chronically implanted leads. In these studies, the effectiveness and safety of only one type of mechanical sheath has been generally presented . No remarkable study is present regarding direct comparison of different rotational mechanical dilator sheaths although few studies comparing different powered extraction tools have been introduced …”

Section: Introductionmentioning

confidence: 99%

Comparison of two types of rotational mechanical dilatator sheath: Evolution^® and TightRail^™

Çay

Özeke

Özcan

et al. 2019

Pacing Clinical Electrophis

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Introduction Powered extraction tools are usually needed in chronically implanted leads. Comparative data are essential among different rotating dilator sheaths. The aim of the study was to compare procedural/clinical outcomes and adverse events in patients underwent lead extraction utilizing two different rotating dilator sheaths. Methods and results The current study was a retrospective review of consecutive patients at a single center. From December 2009 to August 2017, 163 lead extractions from 98 consecutive patients (median, 65 years; 71% male) utilizing a rotating mechanical sheath were analyzed for both efficacy (procedural and clinical success rates) and safety (adverse events). According to the type of the sheath used, the Evolution group (58 patients with 94 leads) and the TightRail group (40 patients with 69 leads) were determined. Extracted device was an implantable cardioverter‐defibrillator (ICD) in two‐thirds of patients. The majority of leads (87.7%) had passive‐fixation mechanism. All ICD leads had dual‐coil design. The median lead implant duration was 4 years, and no difference was found between the two groups. Infectious etiology was the main indication for extraction in 56.1% of patients. There were no statistically significant differences regarding the procedural success rate (96.6% vs 95.0%), clinical success rate (98.3% vs 97.5%), and total adverse event rate (5.2% vs 10.0%) between the Evolution and TightRail groups, respectively. Procedural success decreased with older leads and higher lead number. Conclusions Procedural and clinical success rates utilizing both the Evolution and TightRail rotational extraction sheaths were high with low complication rate in chronically implanted leads.

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“…Ultimately, we chose to use the mechanical cutting sheath because we felt the cutting sheath allowed superior control for disrupting the polypropylene suture adjacent to the thin right atrial wall. The TightRail mechanical cutting sheath 5 uses a bidirectional cutting mechanism to circumferentially cut 0.5 mm beyond the sheath tip with each deployment. We felt one major advantage of the cutting sheath over the laser was to know the exact cutting depth of the sheath.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous extraction of a pulmonary artery catheter inadvertently sewn to the right atrial wall

Rasmussen

Goldsmith

Zahr

et al. 2016

HeartRhythm Case Reports

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Initial experience with the TightRail™ Rotating Mechanical Dilator Sheath for transvenous lead extraction

Cited by 41 publications

References 18 publications

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Comparison of two types of rotational mechanical dilatator sheath: Evolution^® and TightRail^™

Percutaneous extraction of a pulmonary artery catheter inadvertently sewn to the right atrial wall

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Initial experience with the TightRail™ Rotating Mechanical Dilator Sheath for transvenous lead extraction

Cited by 41 publications

References 18 publications

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience

Comparison of two types of rotational mechanical dilatator sheath: Evolution® and TightRail™

Percutaneous extraction of a pulmonary artery catheter inadvertently sewn to the right atrial wall

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Product

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Comparison of two types of rotational mechanical dilatator sheath: Evolution^® and TightRail^™