{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:00Z","timestamp":1753876200988,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Systemic infection of cardiac implantable electronic devices (CIEDs) usually manifests as endocarditis, with vegetations involving the lead and cardiac valves. Cardiac implantable electronic device systemic infections involve the transvenous or epicardial portion of the lead in addition to adjacent endocardium. History, blood cultures, and imaging are the cornerstone of diagnosis. The treatment of CIED infections involves intravenous antibiotics, complete removal of the CIED, and reimplantation after clearance of bacteraemia. AngioVac is used for the removal of right atrial masses, right atrial thrombi, and right-sided endocarditis vegetations. It can provide a mechanism for debulking of lead vegetations prior to their removal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe a case series of five patients who underwent debulking of lead vegetations with AngioVac prior to cardiac implantable electronic device removal. Four of our patients had defibrillators implanted for ventricular tachycardia. Three patients had involvement of the right atrial lead. Staphylococcus aureus was the most common organism involved. All patients had successful debulking of lead vegetations without any intraprocedural complications or 30-day mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Traditionally, large vegetations (&amp;gt;2\u2005cm) involving the CIED apparatus required open surgery before device removal but more recently, AngioVac device has been used for the removal of vegetations from intracardiac leads before their removal, offering an alternative to the traditional surgical approach for high or prohibitive risk patients. Our case series adds to the growing body of evidence supporting the use of AngioVac in debulking leads prior to their removal.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf239","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T18:54:41Z","timestamp":1747335281000},"source":"Crossref","is-referenced-by-count":0,"title":["Use of AngioVac device in debulking endocarditis vegetations before lead extractions"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3445-0275","authenticated-orcid":false,"given":"Mobeen Zaka","family":"Haider","sequence":"first","affiliation":[{"name":"Department of Cardiology, West Virginia University , 1 Medical Center Dr, Morgantown, WV 26506 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6541-3037","authenticated-orcid":false,"given":"Muhammad Hasib","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carle Foundation Hospital, 611 W Park St, Urbana, IL 61801 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4359-3152","authenticated-orcid":false,"given":"Osama","family":"Alsara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carle Foundation Hospital, 611 W Park St, Urbana, IL 61801 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carle Foundation Hospital, 611 W Park St, Urbana, IL 61801 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naveed","family":"Adoni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carle Foundation Hospital, 611 W Park St, Urbana, IL 61801 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuj","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carle Foundation Hospital, 611 W Park St, Urbana, IL 61801 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"2025060205171626600_ytaf239-B1","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1161\/01.CIR.95.8.2098","article-title":"Systemic infection related to endocarditis on pacemaker leads: clinical presentation and management","volume":"95","author":"Klug","year":"1997","journal-title":"Circulation"},{"key":"2025060205171626600_ytaf239-B2","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.1016\/j.hrthm.2017.09.001","article-title":"2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction","volume":"14","author":"Kusumoto","year":"2017","journal-title":"Heart Rhythm"},{"key":"2025060205171626600_ytaf239-B3","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.jacep.2021.01.010","article-title":"Risk factors for repeat infection and mortality after extraction of infected cardiovascular implantable electronic devices","volume":"7","author":"Narui","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"2025060205171626600_ytaf239-B4","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.jacc.2011.04.033","article-title":"16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008","volume":"58","author":"Greenspon","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2025060205171626600_ytaf239-B5","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1540-8159.2006.00328.x","article-title":"Transvenous pacemaker lead removal is safe and effective even in large vegetations: an analysis of 53 cases of pacemaker lead endocarditis","volume":"29","author":"Ruttmann","year":"2006","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025060205171626600_ytaf239-B6","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1002\/clc.21018","article-title":"2011 transvenous extraction of pacemaker leads in infective endocarditis with vegetations \u226520\u2005mm: our experience","volume":"35","author":"P\u00e9rez Baztarrica","year":"2012","journal-title":"Clin Cardiol"},{"key":"2025060205171626600_ytaf239-B7","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.hrthm.2019.11.015","article-title":"Influence of vegetation shape on outcomes in transvenous lead extractions: does shape matter?","volume":"17","author":"Arora","year":"2020","journal-title":"Heart rhythm"},{"key":"2025060205171626600_ytaf239-B8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jvir.2020.09.012","article-title":"Endovascular removal of thrombus and right heart masses using the AngioVac system: results of 234 patients from the prospective, multicenter registry of AngioVac procedures in detail (RAPID)","volume":"32","author":"Moriarty","year":"2021","journal-title":"J Vasc Interv Radiol"},{"key":"2025060205171626600_ytaf239-B9","doi-asserted-by":"crossref","first-page":"101353","DOI":"10.1016\/j.cpcardiol.2022.101353","article-title":"AngioVac for vegetation debulking in right-sided infective endocarditis: a systematic review and meta-analysis","volume":"47","author":"Mhanna","year":"2022","journal-title":"Curr Probl Cardiol"},{"key":"2025060205171626600_ytaf239-B10","first-page":"1923505","article-title":"AngioVac system used for vegetation debulking in a patient with tricuspid valve endocarditis: a case report and review of the literature","volume":"2017","author":"Abubakar","year":"2017","journal-title":"Case Rep Cardiol"},{"key":"2025060205171626600_ytaf239-B11","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/jocs.14009","article-title":"AngioVac for extraction of venous thromboses and endocardial vegetations: a meta-analysis","volume":"34","author":"Hameed","year":"2019","journal-title":"J Card Surg"},{"key":"2025060205171626600_ytaf239-B12","doi-asserted-by":"crossref","first-page":"3291","DOI":"10.19102\/icrm.2018.090803","article-title":"AngioVac debulking in endocarditis patients with large, device-related vegetations","volume":"9","author":"Patel","year":"2018","journal-title":"J Innov Card Rhythm Manag"},{"key":"2025060205171626600_ytaf239-B13","first-page":"e43720","article-title":"Investigating the complications and causes of failure of the AngioVac system: a post-marketing surveillance from the MAUDE database","volume":"15","author":"Dandu","year":"2023","journal-title":"Cureus"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf239\/63198645\/ytaf239.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/6\/ytaf239\/63198645\/ytaf239.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/6\/ytaf239\/63198645\/ytaf239.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T09:17:23Z","timestamp":1748855843000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf239\/8133182"}},"subtitle":[],"editor":[{"given":"Felix","family":"Wiedmann","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Linh","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ugur","family":"Canpolat","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Franca","family":"Morselli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,15]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf239","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,15]]},"article-number":"ytaf239"}}