{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:03:12Z","timestamp":1788498192567,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transvenous lead extraction (TLE) is procedurally complex and carries significant risk. Evidence on optimal TLE techniques is limited and lacks comparative studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Cochrane Library, and Web of Science were searched through November 27, 2024. We included randomized clinical trials (RCTs) or non\u2010randomized controlled trials (non\u2010RCTs) comparing two or more TLE methods in adults undergoing lead extraction. A network meta\u2010analysis was conducted to estimate pooled outcomes with 95% CIs. P\u2010scores ranked treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven non\u2010RCTs and one RCT were included. No statistically significant differences were observed in patient\u2010level clinical success or lead\u2010level procedural success. The femoral approach was associated with a significantly lower risk of significant complications compared to the use of laser sheaths (odds ratio, 0.28; 95% CI, 0.09\u20130.89). Rotating mechanical sheaths (RMS) ranked highest for clinical (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.7470) and procedural success (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.7357), while the femoral approach ranked highest for safety (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.8368). Laser sheaths ranked lowest across all outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No single technique was superior in terms of success rates. RMS and the femoral approach had the highest rankings for efficacy and safety, respectively. Laser sheaths ranked lowest for both. Rigorous prospective studies with direct comparative analyses are required to establish evidence\u2010based protocols and improve TLE patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70052","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T15:46:22Z","timestamp":1758901582000},"page":"1373-1383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Techniques for Transvenous Lead Extraction of Cardiac Implantable Electronic Devices: A Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9308-9209","authenticated-orcid":false,"given":"Charles Karel Martins","family":"Santos","sequence":"first","affiliation":[{"name":"Medical Department School of Medical and Life Sciences Pontifical Catholic University of Goi\u00e1s  Goi\u00e2nia Goi\u00e1s Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8877-3151","authenticated-orcid":false,"given":"Maria Clara Ramos","family":"Miranda","sequence":"additional","affiliation":[{"name":"Medical Department School of Medical and Life Sciences Pontifical Catholic University of Goi\u00e1s  Goi\u00e2nia Goi\u00e1s Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1489-7551","authenticated-orcid":false,"given":"Gabriel Alves","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Medical Department School of Medical and Life Sciences Pontifical Catholic University of Goi\u00e1s  Goi\u00e2nia Goi\u00e1s Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-5206","authenticated-orcid":false,"given":"Ant\u00f4nio da Silva Menezes","family":"J\u00fanior","sequence":"additional","affiliation":[{"name":"Medical Department School 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