Arrhythmias & electrophysiologyCohort study
Shockwave intravascular lithotripsy in transvenous lead extraction of leads with dwell time of ≥10 years
- retrospective cohort study
Authors' conclusion
IVL did not improve procedural efficiency or complexity in our cohort. Partial venous occlusion may represent a risk factor for cardiovascular injury. Further studies of specific patient cohorts, such as those with imaging-proven, lead-associated calcified adhesions, may help define the benefit of IVL in CIED extraction.
Study context
- Population
- Adult patients who underwent CIED extraction since 2020 with at least 1 lead with a dwell time (DT) of ≥10 yearsIntravascular lithotripsy (IVL) 33 · control 91
- Participants
- 33 vs 91
- Exposure
- IVL vs conventional extraction
- IVLn = 33
- controln = 91
- Outcome
- Number of tools used for each patient, clinical success, and fluoroscopy time
Main finding
As reported in the abstract
IVL
39.3
median · range as printed 33.1 minutes, 53.7 minutes · minutes
P = 0.002
Observational data: associations, not effects.
Secondary outcomes
Postprocedure lead function for retained functional leads · median follow-up of 1.25 years [1.24 years, 1.44 years]
- IVL patients who retained functional leads, with stable function after the procedure
- 5
Safety
events
| Outcome | IVL | control |
|---|---|---|
| Major complications · all had lead-related significant venous occlusion | 2 | 3 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Summarised from the published abstract; every number is checked against it