{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:26:50Z","timestamp":1786649210615,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transvenous lead extraction (TLE) is essential for CIED management and is generally safe with contemporary techniques, although rare cardiac or vascular complications can be life\u2010threatening. Comparative data between non\u2010powered telescoping sheaths (TS) and powered rotational sheaths remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>After excluding simple traction cases, 308 consecutive TLE patients treated at a tertiary center (2014\u20132025) were analyzed (73 TS\u2010only; 235 TightRail). Procedural success, efficiency, and complications were compared. Major complications were defined as life\u2010threatening or fatal procedure\u2010related events, or events requiring urgent invasive or surgical intervention. Predictors of major complications were identified using multivariable logistic regression, and a pragmatic risk score (WARD\u201010: Weight &lt;\u200960\u2009kg, Age \u2265\u200974 years, Right subclavian approach, Diabetes mellitus, lead age \u2265\u200910 years) was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The TightRail group included significantly older leads (oldest lead age 7.0\u2009\u00b1\u20095.3 vs. 11.4\u2009\u00b1\u20096.8 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Complete and clinical success were similar between TS\u2010only and TightRail (91.8% vs. 94.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.586; 93.2% vs. 95.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.545), and overall procedure and fluoroscopy times did not differ significantly. In three\u2010group analysis, TightRail\u2010only demonstrated the shortest procedural duration. Major complication rates did not differ significantly between the TS\u2010only and TightRail groups (1.4% vs. 4.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.469); these events predominantly occurred in leads \u2265\u200910 years, whereas complication rates were low regardless of extraction strategy in leads &lt;\u200910 years. Independent predictors of major complications were weight &lt;\u200960\u2009kg, right subclavian approach, diabetes mellitus, and lead age \u2265\u200910 years. WARD\u201010 demonstrated good discrimination (AUC 0.857); a cutoff \u2265\u20093 yielded 72.7% sensitivity and 85.5% specificity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TightRail achieved comparable efficacy and efficient performance despite preferential use in more complex cases. Major complications were primarily associated with patient\u2010 and lead\u2010related risk factors rather than the extraction strategy alone. The WARD\u201010 score provides a simple tool for individualized risk stratification in TLE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70460","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:31:30Z","timestamp":1786645890000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Powered Rotational Sheaths in Complex Transvenous Lead Extraction: Comparative Outcomes With Telescoping Sheaths and the WARD\u201010 Score"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3992-0128","authenticated-orcid":false,"given":"Seongjin","family":"Park","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Chan","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Kangbuk Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juwon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Youn","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung\u2010Min","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Keun","family":"On","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung\u2010Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv245"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux020"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.070"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2023.06"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2022.08.006"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42444\u2010022\u201000076\u2010w"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2022.02.024"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccep.2023.10.011"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2024.11.010"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471\u2010021\u201001652\u2010w"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac200"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.10.019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020361"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euy050"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0894\u20107317(03)00335\u20103"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2018.07.011"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15006"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13755"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201099901\u2010w"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad316"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.11.022"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.08.002"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.70280"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaa278"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192114184"},{"key":"e_1_2_12_28_1","volume-title":"Anatomy, Thorax, Brachiocephalic (Innominate) Veins","author":"Woodhouse P.","year":"2025"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.302968"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.116.306256"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010024\u201002502\u2010w"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.02.015"},{"issue":"24","key":"e_1_2_12_33_1","doi-asserted-by":"crossref","first-page":"7568","DOI":"10.3390\/jcm12247568","article-title":"LECOM (Lead Extraction COMplexity): A New Scoring System for Predicting a Difficult Procedure","volume":"12","author":"Jache\u0107 W.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx080"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw255"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70460","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70460","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:31:32Z","timestamp":1786645892000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":34,"alternative-id":["10.1111\/jce.70460"],"URL":"https:\/\/doi.org\/10.1111\/jce.70460","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"assertion":[{"value":"2026-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jce.70460"}}