The fate of permanent intracardiac electrodes

Parsonnet, Victor; Zucker, I. Richard; Kannerstein, M; Gilbert, Lawrence; Alvares, Jose Filipe

doi:10.1016/s0022-4804(66)80039-2

Cited by 43 publications

(8 citation statements)

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“…Organized clot, surrounding the pacing lead, which was observed ultrasonographycally in those 2 patients, is a normal finding accompanying biological conditioning of all indwelling devices, and thus implanted endovenous leads as well 7–11 . In our opinion, our encouraging results could be (at least partially) explained by the fact, that all endovenous lead implantations were performed via cephalic vein, instead of subclavian vein puncture.…”

Section: Discussionmentioning

confidence: 59%

Prevalence of Venous Obstruction in Permanent Endovenous Pacing in Newborns and Infants: Follow‐Up Study

Stojanov¹,

Vranes²,

Velimirović³

et al. 2005

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 59%

Prevalence of Venous Obstruction in Permanent Endovenous Pacing in Newborns and Infants: Follow‐Up Study

Stojanov¹,

Vranes²,

Velimirović³

et al. 2005

Pacing Clinical Electrophis

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“…Animal investigations confirm that fibrous encapsulation of leads occurred almost in all instances,7, 15, 16 even though the tissue response appeared to be influenced by the surface characteristics of the tip electrode 17–19. Parsonnet et al7 described thicker collagen sheaths around semirough and rough polyurethane insulated catheters when compared to smooth ones. However, the relationships between material surface properties and wound healing in blood and soft tissues are not fully understood 20…”

Section: Introductionmentioning

confidence: 94%

“…A postmortem investigation on 11 hearts revealed that leads, mainly with silicon rubber insulation, were almost always covered by a scar‐like tissue in the ventricle, whereas a less prominent fibrotic response was observed in the atria 14. Animal investigations confirm that fibrous encapsulation of leads occurred almost in all instances,7, 15, 16 even though the tissue response appeared to be influenced by the surface characteristics of the tip electrode 17–19. Parsonnet et al7 described thicker collagen sheaths around semirough and rough polyurethane insulated catheters when compared to smooth ones.…”

Section: Introductionmentioning

confidence: 96%

“…It has been suggested that once inserted, portions of the lead are endothelialized and incorporated into the vessel walls 6. The intracardiac portion of the lead is partly encapsulated by fibrocollagenous tissue, in particular at the tip 6–14. The tissue capsule formed around the lead bodies as well as the intracardiac fibrotic encapsulation of tined or screwed‐in lead tips renders removal of leads difficult.…”

Section: Introductionmentioning

confidence: 99%

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Morphologic and immunohistochemical observations of tissues surrounding retrieved transvenous pacemaker leads

Esposito

Kennergren

Holmstrom

et al. 2002

J. Biomed. Mater. Res.

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Immunohistochemical and morphologic techniques were employed to evaluate the tissue response around chronically implanted pacing leads. Seventeen leads were retrieved from 12 patients. Leads were extracted by direct manual traction (1), extraction with sheaths and locking stylets (1), or with by a combination of mechanical tools and Excimer laser sheaths (15). Mean lead implantation time was 5.6 years (range 1-8 years). Frozen sections, 6-8 microm thick, were incubated with antibodies against HLA-DR antigen, endothelial cells, macrophages, T cells, plasma cells, fibrinogen, and interleukin-1beta. Prominent morphologic observations were fibrous encapsulations of the leads. Immunohistochemical analysis revealed a tissue generally devoid of inflammatory and immune cells. The fibrous capsule surrounding the lead was partially or completely covered with a monolayer of CD34 expressing endothelial cells. The results from this study provide useful information in design and material selection for pacemaker leads. Endothelialization of the fibrous encapsulation indicates a functionalization of blood-contacting surfaces around pacemaker materials, thus providing a mechanism for long-term persistence of foreign materials in the blood. The laser method allowed an efficient extraction of pacemaker leads without damage to the studied tissues, as suggested by the presence of immunolabeled cells close to the cut surfaces.

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“…Thrombus was absent. COMMENT Soon after a catheter has been placed within the heart, a thin layer of fibrin is deposited which does not get thicker with the passage of time (Lagergren, Dahilgren, and Nordenstam, 1966;Parsonnet, Zucker, Kannerstein, Gilbert, and Alvares, 1966). Piresumably fibrinolysis and fibrin deposition reach an equilibrium.…”

Section: Case Summarymentioning

confidence: 99%