{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:52:19Z","timestamp":1792072339656,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"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) for cardiac implantable electronic device infection has high procedural success, but with a 1\u2010year mortality approaching 25%. Potential mechanisms include septic embolization and persistent infected lead casts or \u201cghosts.\u201d Percutaneous mechanical aspiration of lead\u2010related vegetations during TLE is a potential strategy to reduce vegetation burden, but safety and outcomes data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe a multicenter experience utilizing percutaneous vegetation aspiration during TLE, including vegetation characteristics, procedural techniques, complications, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective multicenter registry included patients undergoing aspiration of lead\u2010related masses at the time of TLE between 2016 and 2024 across six institutions. Clinical, microbiologic, and procedural data were collected. Vegetation size and outcomes were assessed using transesophageal or intracardiac echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty\u2010three patients (62\u2009\u00b1\u200914 years, 28% female) underwent aspiration of 63 vegetations during extraction of 114 leads (mean dwell time 9.0\u2009\u00b1\u20098.2 years). Indications included bacteremia in 44 (83%), fungemia in 4 (8%), fever of unknown origin in 1 (2%), and aseptic thrombus debulking in 4 (8%). Mean vegetation size was 2.8\u2009\u00b1\u20091.8\u2009cm. Aspiration devices included Penumbra Indigo (34%), Inari FlowTriever (30%), and AngioVac (36%). Complete aspiration occurred in 40 patients (75%). TLE achieved complete success in 49 (92%) and clinical success in 52 (98%). Major complications related to aspiration occurred in 2 patients (4%). After a median follow\u2010up of 139 days, 10 patients (19%) died.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Percutaneous vegetation aspiration during TLE appears feasible and generally safe. However, mortality following extraction for device\u2010related infection remains substantial, and the impact of adjunctive aspiration on outcomes requires further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70530","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:32:53Z","timestamp":1792071173000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Outcomes of Percutaneous Vegetation Aspiration During Transvenous Lead Extraction: A Multicenter Experience"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2697-026X","authenticated-orcid":false,"given":"Haran","family":"Yogasundaram","sequence":"first","affiliation":[{"name":"Division of Cardiology, Mazankowski Alberta Heart Institute University of Alberta Hospital Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1568-5072","authenticated-orcid":false,"given":"Wissam","family":"Mekary","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiology Division\u2010Section of Electrophysiology Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4978-7177","authenticated-orcid":false,"given":"Mikhael F.","family":"El\u2010Chami","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiology Division\u2010Section of Electrophysiology Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Trulock","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Community Heart and Vascular Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Healy","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Community Heart and Vascular Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Morsani College of Medicine University of South Florida Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2227-1752","authenticated-orcid":false,"given":"Ryan","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Morsani College of Medicine University of South Florida Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Mehta","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish K.","family":"Misra","sequence":"additional","affiliation":[{"name":"Sanger Heart and Vascular Institute Atrium Health Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divyang R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Sentara Norfolk General Hospital Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich L.","family":"Kiehl","sequence":"additional","affiliation":[{"name":"Sentara Norfolk General Hospital Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7962-9423","authenticated-orcid":false,"given":"Francis E.","family":"Marchlinski","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Cardiac Electrophysiology Section Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-7247","authenticated-orcid":false,"given":"Robert D.","family":"Schaller","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Cardiac Electrophysiology Section Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"252","article-title":"Long\u2010Term Mortality After Transvenous Lead Extraction","volume":"5","author":"Maytin M.","year":"2012","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1001\/archinternmed.2011.441","article-title":"Mortality and Cost Associated With Cardiovascular Implantable Electronic Device Infections","volume":"171","author":"Sohail M. 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