STUDY PATIENTS AND DESIGN
Our cohort included all 421 consecutive patients undergoing TLE between May 2010 and February 2020 at Sheba Medical Center, a large tertiary university medical center in Israel. The clinical and procedural data of all TLE procedures were collected prospectively. Lead extraction was defined as any lead removal in which at least one lead required the assistance of equipment not typically used during implantation or at least one lead implanted for more than one year 10.
The superior approach group comprised all patients in whom the subclavian / axillary vein was the only approach used for lead extraction. Femoral approach was only used as a bailout solution in cases of unsuccessful superior TLE approach, and included all TLE patients in whom at least one of the leads was extracted through the femoral vein.
Venography is routinely performed before a system upgrade, and when the access vein is found to be occluded we recommend that an older lead be removed to gain venous access. We also perform venography on a case by case basis before substituting broken or malfunctioning leads.
The study and TLE registry was approved by the Institutional Review Board.
he clinical and procedural
data were collected prospectively from the procedural report and
patients’ records
he clinical and procedural
data were collected prospectively from the procedural report and
patients’ records