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Initial experience with the Evolution mechanical dilator sheath for lead extraction: Safety and efficacy

Show simple item record Hussein A.A. Wilkoff B.L. Martin D.O. Karim S. Kanj M. Callahan T. Baranowski B. Saliba W.I. Wazni O.M.
dc.contributor.editor 2010 2017-10-05T15:42:20Z 2017-10-05T15:42:20Z 2010
dc.identifier 10.1016/j.hrthm.2010.03.019
dc.identifier.issn 15475271
dc.description.abstract Background: The Evolution mechanical dilator sheath is a new lead extraction tool that uses a rotational mechanism and a bladed tip to overcome fibrosis. Objective: The purpose of this study was to report our initial experience with the Evolution system. Methods: Between March 2008 (our first use of Evolution) and September 2009, the Evolution sheath was used for extraction of pacemaker or implantable cardioverter-defibrillator (ICD) leads in 29 patients (41 leads). Success and complications were defined according to the Heart Rhythm Society expert consensus document on lead extraction. Results: Indications for extraction were infection in 20 patients and lead malfunction in 9 patients. Median implantation time was 65 months (range 12-409 months). Of the 41 leads, 18 (44percent) were atrial and 23 (56percent) were ventricular. ICD leads were extracted from 14 (48percent) patients and pacemaker leads from 15 (52percent) patients. Evolution was used as first choice in 12 patients (16 [39percent] leads), with 100percent clinical success. Complete procedural success was achieved in 11 patients; in 1 patient, only the distal electrode was retained. The system was used for rescue of 25 (61percent) leads in 17 patients. Success with Evolution alone was achieved in 13 (77percent) patients (Shortie Evolution sheath used in 2), for complete procedural success of 77percent. However, in 4 (24percent) patients, Evolution was useful but not sufficient for complete procedural success (femoral workstation required in 2, reuse of laser in 2). Overall, the Evolution system was successful in 25 (86percent) patients (33 leads). Overall clinical success was 100percent. No complications occurred. Conclusion: Preliminary data suggest that the Evolution mechanical dilator sheath is a new useful tool among the instruments available for lead extraction. © 2010 Heart Rhythm Society.
dc.format.extent Pages: (870-873)
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Heart Rhythm; Publication Year: 2010; Volume: 7; no. 7; Pages: (870-873);
dc.source Scopus
dc.title Initial experience with the Evolution mechanical dilator sheath for lead extraction: Safety and efficacy
dc.type Article
dc.contributor.affiliation Hussein, A.A., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Wilkoff, B.L., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Martin, D.O., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Karim, S., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Kanj, M., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Callahan, T., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Baranowski, B., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Saliba, W.I., Cleveland Clinic, Cleveland, OH, United States
dc.contributor.affiliation Wazni, O.M., Cleveland Clinic, Cleveland, OH, United States, Cardiovascular Medicine, American University of Beirut, Beirut, Lebanon
dc.contributor.authorAddress Wazni, O.M.; Cleveland Clinic, Cleveland, OH, United States; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Cardiovascular Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Cardiovascular Medicine
dc.contributor.faculty Faculty of Medicine
dc.contributor.authorInitials Hussein, AA
dc.contributor.authorInitials Wilkoff, BL
dc.contributor.authorInitials Martin, DO
dc.contributor.authorInitials Karim, S
dc.contributor.authorInitials Kanj, M
dc.contributor.authorInitials Callahan, T
dc.contributor.authorInitials Baranowski, B
dc.contributor.authorInitials Saliba, WI
dc.contributor.authorInitials Wazni, OM
dc.contributor.authorReprintAddress Wazni, OM (reprint author), Amer Univ Beirut, Beirut, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited Al-Khadra AS, 2001, INTERVENTIONAL ELECT, P819; Bongiorni MG, 2008, EUR HEART J, V29, P2886, DOI 10.1093-eurheartj-ehn461; Borek PP, 2008, J INTERV CARD ELECTR, V23, P59, DOI 10.1007-s10840-008-9249-7; Epstein LM, 1999, CIRCULATION, V100, P516; GOODE L B, 1991, Biomedical Instrumentation and Technology, V25, P50; Kennergren C, 2007, EUROPACE, V9, P651, DOI 10.1093-europace-eum098; Neuzil P, 2007, EUROPACE, V9, P98, DOI 10.1093-europace-eul171; Smith MC, 2008, PACE, V31, P736, DOI 10.1111-j.1540-8159.2008.01079.x; Wilkoff BL, 2009, HEART RHYTHM, V6, P1085, DOI 10.1016-j.hrthm.2009.05.020; Wilkoff BL, 1999, J AM COLL CARDIOL, V33, P1671, DOI 10.1016-S0735-1097(99)00074-1
dc.description.citedCount 24
dc.description.citedTotWOSCount 19
dc.description.citedWOSCount 19
dc.format.extentCount 4
dc.identifier.coden HREHA
dc.identifier.pubmedID 20346418
dc.identifier.scopusID 77953839609
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
dc.relation.ispartOfISOAbbr Heart Rhythm
dc.relation.ispartOfIssue 7
dc.relation.ispartofPubTitle Heart Rhythm
dc.relation.ispartofPubTitleAbbr Heart Rhythm
dc.relation.ispartOfVolume 7
dc.source.ID WOS:000279310400002
dc.type.publication Journal
dc.subject.otherAuthKeyword Evolution sheath
dc.subject.otherAuthKeyword Lead extraction
dc.subject.otherIndex adult
dc.subject.otherIndex article
dc.subject.otherIndex artificial heart pacemaker
dc.subject.otherIndex cardiovascular equipment
dc.subject.otherIndex clinical article
dc.subject.otherIndex clinical effectiveness
dc.subject.otherIndex controlled study
dc.subject.otherIndex defibrillator
dc.subject.otherIndex device infection
dc.subject.otherIndex female
dc.subject.otherIndex human
dc.subject.otherIndex male
dc.subject.otherIndex mechanical dilator sheath
dc.subject.otherIndex pacemaker failure
dc.subject.otherIndex pacemaker lead infection
dc.subject.otherIndex pacemaker lead malfunction
dc.subject.otherIndex patient safety
dc.subject.otherIndex priority journal
dc.subject.otherIndex treatment indication
dc.subject.otherIndex Defibrillators, Implantable
dc.subject.otherIndex Device Removal
dc.subject.otherIndex Electrodes, Implanted
dc.subject.otherIndex Equipment Design
dc.subject.otherIndex Humans
dc.subject.otherIndex Pacemaker, Artificial
dc.subject.otherIndex Prosthesis-Related Infections
dc.subject.otherKeywordPlus ICD LEADS
dc.subject.otherKeywordPlus PACEMAKER
dc.subject.otherKeywordPlus REMOVAL
dc.subject.otherKeywordPlus TRIAL
dc.subject.otherWOS Cardiac and Cardiovascular Systems

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