Pacing lead extraction using an excimer laser sheath under general anesthesia

Satoshi Kimura, Yuichiro Toda, Kentaro Sugimoto, Noriko Ishii, Kazuyoshi Shimizu, Tomohiko Suemori, Tatsuo Iwasaki, Kiyoshi Morita

Research output: Contribution to journalArticle

Abstract

An excimer laser sheath has recently been used for extraction of pacing and ICD leads. By using this technique, leads are removed more easily and it has to take a shorter time to extract leads. Although lead extraction with this method can cause fatal complications such as large vessel injury, little has been reported regarding anesthetic management during the lead extraction. We experienced two cases of pacing lead extraction using an excimer laser sheath under general anesthesia. The procedures were mainly performed by cardiologists in the operating theater. A wide area was prepared with sterile drapes as for cardiac surgery with cardiovascular surgeons standing by. Vascular access catheters were placed in the right femoral artery as well as vein, and in the right internal jugular vein so that immediate PCPS introduction could be performed in case of sudden hemodynamic collapse by massive bleeding. In the first case, lead extraction was completed without any complication, but in the second case sternotomy was performed by cardiac surgeons for safe separation of leads from vessels. There were also no bleeding episodes in the second case. Preparation for bleeding and cooperation among cardiologists, cardiovascular surgeons, medical engineers and anesthesiologists are necessary from the safety point of view of this procedure under general anesthesia.

Original languageEnglish
Pages (from-to)1277-1280
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume61
Issue number11
Publication statusPublished - Nov 1 2012

Keywords

  • Anesthetic management
  • Excimer laser sheath
  • Fatal complication
  • Pacing lead extraction

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Kimura, S., Toda, Y., Sugimoto, K., Ishii, N., Shimizu, K., Suemori, T., Iwasaki, T., & Morita, K. (2012). Pacing lead extraction using an excimer laser sheath under general anesthesia. Japanese Journal of Anesthesiology, 61(11), 1277-1280.