{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:52:46Z","timestamp":1783734766449,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T00:00:00Z","timestamp":1723334400000},"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":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Extraction of a broken lead fragment (BLF) has received scant attention in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis was to compare the effectiveness of different approaches and tools used for BLF removal during 127 procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A superior approach was the most popular (75.6%), femoral (15.7%) and combined (8.7%) approaches were the least common. Of 127 BLFs 78 (61.4%) were removed in their entirety and BLF length was significantly reduced to less than 4\u2009cm in 21 (16.5%) or lead tip in 12 (9.4%) cases. The best results were achieved when BLFs were longer (&gt;4\u2009cm) (62\/93 66.7% of longer BLFs), either in the case of BLFs free\u2010floating in vascular bed including pulmonary circulation (68.4% of them) but not in cases of short BLFs (20.0% of short BLFs). Complete procedural success was achieved in 57.5% of procedures, the lead tip retained in the heart wall in 12 cases (9.4%) and short BLFs were found in 26.0%, whereas BLFs &gt;4\u2009cm were left in place in four cases (3.1%) of procedures only. There was no relationship between approach in lead remnant removal and long\u2010term mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>(1) Effectiveness of fractured lead removal is satisfactory: entire BLFs were removed in 61.4% (total procedural success\u201457.5%, was lower because five major complications occurred) and BLF length was significantly reduced in 26.0%. (2) Among the broken leads, leads with a long stay in the patient (16.3 years on average), passive leads (97.6%) and pacemaker leads 92.1% are significantly more common, but not ICD leads (only 7.9% of lead fractures) compared to TLE without lead fractures. (3) Broken lead removal (superior approach) using a CS access sheath as a \u201csubclavian workstation\u201d for continuation of dilatation with conventional tools deserves attention. (4) Lead fracture management should become an integral part of training in transvenous lead extraction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16398","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T05:30:20Z","timestamp":1723440620000},"page":"1981-1996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Removal of leads broken during extraction: A comparison of different approaches and tools"],"prefix":"10.1111","volume":"35","author":[{"given":"Andrzej","family":"Kutarski","sequence":"first","affiliation":[{"name":"Department of Cardiology Medical University of Lublin Lublin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Jache\u0107","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze Medical University of Silesia Katowice 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