Arrhythmias & electrophysiologyCohort study
Pre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction
- Retrospective cohort study
- Mean lead dwelling time 95 ± 73 months
Authors' conclusion
Pre-procedural CT allows accurate identification of high-risk anatomical features, particularly fibrosis length and calcifications, which independently predict both complicated and complex rotational mechanical TLE.
Study context
- Population
- Patients undergoing rotational mechanical transvenous lead extraction (TLE) with pre-procedural contrast-enhanced computed tomography (CT)215 leads extracted
- Participants
- 115 patients
- Outcome
- Complicated procedure (major complication, incomplete lead removal or snare use) and complex procedure (snare or tissue stabilization sheath)
Main finding
As reported in the abstract
Complicated and complex procedures
- Complicated procedures
- 20.9%
- Complicated procedure independently associated with longest fibrosis length on CT (OR)
- 1.1; P < 0.001
- Fibrosis length >40 mm predicting complicated procedure
- AUC 0.92; 0.88-0.97 (95% CI)
- Complex procedures
- 37.4%
- Fibrosis length >30 mm predicting complex procedure
- AUC 0.72; 0.64-0.81 (95% CI)
Observational data: associations, not effects.
Original publication
Pre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction. Europace. Published 6 December 2025. doi:10.1093/europace/euaf308
Summarised from the published abstract; every number is checked against it