经下腔静脉途径拔除起搏导线的初步体会

目的 介绍应用血管内反推力技术经下腔静脉途径拔除起搏导线的初步临床体会。方法 对１８例患者的２８根导线应用血管内反推力牵引技术拔除导线，其中１６例（２５根导线）首选经上腔静脉途径，失败后改用经下腔静脉途径；２例（３根导线）直接用经下腔静脉途径拔除。结果 １６例患者的２５根导线，经上腔静脉途径完全拔除２２根（８８％），３根经此途径拔除失败后改用下腔静脉途径，其中２根完全拔除。２例患者的３根导线直接先

Lead extraction via inferior vena cava approach

Objective To introduce intravascular countertraction technique for lead extraction via inferior vena cava approach. Methods Twenty eight leads from 18 patients were extracted using intravascular countertraction techniques.25 of the 28 leads(16 cases)were extracted preliminarily via superior vena cava approach and then via inferior vena cava approach after unsuccessful attempts.The inferior vena cava approach was directly used in 3 leads from 2 patients. Results Twenty two of the 25 leads(88%) were completely removed from superior vena cava approach and 2 of the 3 leads failed via this way were extracted from inferior vena cava approach.The other 3 leads were removed via the inferior vena cava approach.Therefore,the total successful rate with the two approaches was 96.4%(27/28).One ventricular lead which was unextracted with the two approaches then was removed by cardiothoracic surgery.There were no severe complication during or post procedure. Conclusion Inferior vena cava approach for lead extraction can be used either as a secondary approach after unsuccess from the superior approach or as a preliminary method.The successful rate was increased in combination of the two approaches.