{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T17:06:41Z","timestamp":1758906401562,"version":"3.37.3"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transvenous lead extraction (TLE) is an important part of comprehensive lead management. The selection of tools available has expanded in recent years but data on their efficacy is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate outcomes using the TightRail\u2122 mechanical rotating mechanical dilator sheath in comparison to excimer laser sheaths and describe factors predictive of successful extraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing TLE at a single tertiary center (2013\u20132019) were included in a prospective registry. Leads targeted for extraction with either an SLS II\/Glidelight\u2122 or TightRail\u2122 sheath were included. Outcomes were analyzed on a per\u2010lead basis. Generalized estimating equation (GEE) models were used to assess differences in lead extraction success by extraction tool used while adjusting for nonindependence of multiple leads extracted from the same patient. Covariates included patient comorbidities, lead characteristics, and sheath size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 575 leads extracted from 372 patients were included. Overall success rate was 97%. TightRail\u2122 was the first tool used in 180 (31.3%) leads with success rate of 61.7%; laser sheaths were the first tool in 395 leads (68.7%) with success rate of 67.8%. Predictors of successful extraction included lead age, lead type, and sheath sizing. Extraction success did not differ based on whether a laser or TightRail\u2122 sheath was used (adjusted odds ratio\u2009=\u20090.94; 95% confidence interval\u2009=\u20090.59\u20131.50).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TightRail\u2122 sheath is an effective tool for TLE. Lead age, lead type, and sheath sizing were predictive of successful extraction but sheath type was not. These findings are hypothesis generating and warrant further investigation in a prospective, randomized study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15105","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T10:52:18Z","timestamp":1621853538000},"page":"1969-1978","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of transvenous lead extraction using the TightRail\u2122 mechanical rotating dilator sheath and excimer laser sheath"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1214-5568","authenticated-orcid":false,"given":"Satish","family":"Misra","sequence":"first","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamala","family":"Swayampakala","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Coons","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Cerbie","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angello","family":"Guifarro","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Lesiczka","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Holshouser","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8567","authenticated-orcid":false,"given":"Jeko","family":"Madjarov","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-499X","authenticated-orcid":false,"given":"Charles","family":"Love","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Mehta","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health  Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013801"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.070"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00074-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux020"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.12.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.03.019"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13700"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv245"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.12.013"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.02.031"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.05.014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.004"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.02.005"},{"key":"e_1_2_7_16_1","unstructured":"United States Food and Drug Administration.Traditional 510(k) \u2010 TightRail(TM) Mechanical Dilator Sheath Set.;2014.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf14\/K140047.pdf"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13755"},{"key":"e_1_2_7_18_1","first-page":"78","article-title":"Results of the Lead Extraction Device Evaluation and Results (LEADER) Database","volume":"9","author":"Love CJ","year":"2012","journal-title":"J Heart Dis"}],"container-title":["Journal of Cardiovascular 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