Arrhythmias & electrophysiologyMeta-analysis
Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis
- Systematic review and meta-analysis
Authors' conclusion
Non-laser TLE is associated with a better safety and efficacy profile when compared with laser methods. There is a greater risk of SVC injury associated with laser sheath extraction.
Study context
- Population
- Patients undergoing transvenous lead extraction (TLE), studies published 1991–202168 studies
- Comparison
- Non-laser vs laser transvenous lead extraction
Pooled result
As reported in the abstract
Safety and efficacy of TLE: procedural mortality, major complications, SVC injury, complete and clinical success (pooled rates, OR)
Non-laser
0%
Procedural mortality · Major complications 0.7% · superior vena cava (SVC) injury 0% · Complete success 96.5%
Laser
0.1%
Procedural mortality · Major complications 1.7% · SVC injury 0.5% · Complete success 93.8%
Non-laser vs LaserOdds ratio (CI)P value
clinical success
2.16(1.77–2.63)
P < 0.01complete success
1.87(1.69–2.08)
P < 0.01lower procedural mortality risk with non-laser
1.6(1.02–2.5)
P < 0.05Further pooled results
| Outcome | Non-laser | Laser | P value |
|---|---|---|---|
| Complete success and SVC injury, rotational tool vs laser (subgroup) | |||
| Complete success (pooled rate) | Not reported in the abstract | 95% | P < 0.01 |
| SVC injury (pooled rate) | Not reported in the abstract | 0.7% | P < 0.01 |
- Complete success and SVC injury, rotational tool vs laser (subgroup): Rotational tool Complete success (pooled rate) 97.4% · SVC injury (pooled rate) 0%
Original publication
Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis. Europace. Published 26 October 2023. doi:10.1093/europace/euad316
Summarised from the published abstract; every number is checked against it