Evidence map›Paper›PMID 36352816›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023

A head-to-head comparison of laser vs. powered mechanical sheaths as first choice and second line extraction tools.

Elod-Janos Zsigmond, Laszlo Saghy, Attila Benak, Marton Miklos, Attila Makai, Zoltan Hegedus, Endre Alacs, Szilvia Agocs, Mate Vamos

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Pooled it
  3. Safety and success of transvenous lead extraction using excimer laser sheaths: a meta-analysis of over 1700 patients.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Pooled it
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  6. Procedural outcomes of transvenous lead extraction in patients with abandoned leads: experience from a large single centre.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
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  10. Extraction outcomes of implantable cardioverter-defibrillator leads vary by manufacturer and model family.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  11. Cardiac pacing and lead devices management: 25 years of research at EP Europace journal.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Review
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Elod-Janos ZsigmondCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.ORCID 0000-0002-6487-3690
Laszlo SaghyCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.
Attila BenakCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.ORCID 0000-0002-6143-8933
Marton MiklosCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.
Attila MakaiCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.
Zoltan HegedusHeart Surgery Department, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.
Endre AlacsDepartment of Anaesthesiology and Intensive Therapy, University of Szeged, Semmelweis str. 6, 6725 Szeged, Hungary.ORCID 0000-0003-2969-8484
Szilvia AgocsDepartment of Anaesthesiology and Intensive Therapy, University of Szeged, Semmelweis str. 6, 6725 Szeged, Hungary.ORCID 0000-0001-5007-4647
Mate VamosCardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis str. 8, 6725 Szeged, Hungary.ORCID 0000-0003-1611-4443
University of Szeged · HU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDuring transvenous lead extraction (TLE) longer dwelling time often requires the use of powered sheaths. This study aimed to compare outcomes with the laser and powered mechanical tools. METHODS AND

resultsSingle-centre data from consecutive patients undergoing TLE between 2012 and 2021 were retrospectively analysed. Efficacy and safety of the primary extraction tool were compared. Procedures requiring crossover between powered sheaths were also analysed. Moreover, we examined the efficacy of each level of the stepwise approach. Out of 166 patients, 142 (age 65.4 ± 13.7 years) underwent TLE requiring advanced techniques with 245 leads (dwelling time 9.4 ± 6.3 years). Laser sheaths were used in 64.9%, powered mechanical sheaths in 35.1% of the procedures as primary extraction tools. Procedural success rate was 85.5% with laser and 82.5% with mechanical sheaths (P = 0.552). Minor and major complications were observed in similar rate. Procedural mortality occurred only in the laser group in the case of three patients. Crossover was needed in 19.5% after laser and in 12.8% after mechanical extractions (P = 0.187). Among crossover procedures, only clinical success favoured the secondary mechanical arm (87.1 vs. 54.5%, aOR: 0.09, 95% CI: 0.01-0.79, P = 0.030). After step-by-step efficacy analysis, procedural success was 64.9% with the first-line extraction tool, 75.1% after crossover, 84.5% with bailout femoral snare, and 91.8% by non-emergency surgery.

conclusionThe efficacy and safety of laser and mechanical sheaths were similar, however in the subgroup of crossover procedures mechanical tools had better performance regarding clinical success. Device diversity seems to help improving outcomes, especially in the most complicated cases.

Indexed as

Defibrillators, ImplantablePacemaker, ArtificialAgedDevice RemovalHumansLasersMiddle AgedRetrospective StudiesTreatment OutcomeCIEDLaser sheathMechanical sheathPrimary extraction toolTransvenous lead extraction

Identifiers

PMID36352816
PMCPMC9935030
OpenAlexW4308688146

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.