Safety and success of transvenous lead extraction using excimer laser sheaths: a meta-analysis of over 1700 patients.
Europace
; 25(11)2023 11 02.
Article
em En
| MEDLINE
| ID: mdl-37757839
ABSTRACT
AIMS:
While numerous studies have demonstrated favourable safety and efficacy of the excimer laser sheath for transvenous lead extraction (TLE) in smaller cohorts, comprehensive large-scale investigations with contemporary data remain scarce. This study aims to evaluate the safety and performance of laser-assisted TLE through a meta-analysis of contemporary data. METHODS ANDRESULTS:
A systematic literature search was conducted to identify articles that assessed the safety and performance of the spectranetics laser sheath (SLS) II and GlideLight Excimer laser sheaths in TLE procedures between 1 April 2016 and 31 March 2021. Safety outcomes included procedure-related death and major/minor complications. Performance outcomes included procedural and clinical success rates. A random-effects, inverse-variance-weighting meta-analysis was performed to obtain the weighted average of the evaluated outcomes. In total, 17 articles were identified and evaluated, including 1729 patients with 2887 leads. Each patient, on average, had 2.3 ± 0.3 leads with a dwell time of 7.9 ± 3.0 years. The TLE procedural successes rate was 96.8% [1440/1505; 95% CI (94.9-98.2%)] per patient and 96.3% [1447/1501; 95% CI (94.8-97.4%)] per lead, and the clinical success rate per patient was 98.3% [989/1010, 95% CI (97.4-99.0%)]. The procedure-related death rate was 0.08% [7/1729, 95% CI (0.00%, 0.34%)], with major and minor complication rates of 1.9% [41/1729; 95% CI (1.2-2.8%)] and 1.9% [58/1729; 95% CI (0.8-3.6%)], respectively.CONCLUSION:
This meta-analysis demonstrated that excimer laser sheath-assisted TLE has high success and low procedural mortality rates. It provides clinicians with a reliable and valuable resource for extracting indwelling cardiac leads which require advanced extraction techniques.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Remoção de Dispositivo
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Europace
Assunto da revista:
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Reino Unido