Academic Journal
Subclinical Venous Injury in Transvenous Lead Extraction: Histological Correlation With Clinical Risk Factors.
| Τίτλος: | Subclinical Venous Injury in Transvenous Lead Extraction: Histological Correlation With Clinical Risk Factors. |
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| Συγγραφείς: | Lateef AU; Department of Medicine, Mayo Clinic, Jacksonville, Florida, USA., Vardar U; Department of Cardiology, Mayo Clinic, Jacksonville, Florida, USA., Hochwald A; Department of Cardiology, Mayo Clinic, Jacksonville, Florida, USA., Nassar A; Department of Research, Mayo Clinic, Jacksonville, Florida, USA., Ladas T; Department of Pathology, Mayo Clinic, Jacksonville, Florida, USA., Chiriac A; Electrophysiology & Cardiac Devices, Lee Health Heart Institute, Fort Myers, Florida, USA., Niekerk CV; Department of Cardiovascular Medicine, Division of Heart Rhythm, Mayo Clinic, Jacksonville, Florida, USA., Kusumoto F; Department of Cardiovascular Medicine, Division of Heart Rhythm, Mayo Clinic, Jacksonville, Florida, USA., Kella DK; Department of Cardiovascular Medicine, Division of Heart Rhythm, Mayo Clinic, Jacksonville, Florida, USA. |
| Πηγή: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2026 Sep; Vol. 37 (9), pp. 1964-1971. Date of Electronic Publication: 2026 Jul 08. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Malden, MA : Blackwell Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| Ιατρικοί όροι (MeSH): | Device Lead Extraction*/adverse effects , Vascular System Injuries*/etiology , Vascular System Injuries*/pathology , Defibrillators, Implantable*/adverse effects , Pacemaker, Artificial*/adverse effects , Veins*/injuries , Veins*/pathology , Veins*/chemistry, Elastin/analysis ; Humans ; Female ; Risk Factors ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Time Factors ; Retrospective Studies ; Risk Assessment |
| Περίληψη: | Background: Transvenous lead extraction (TLE) is a commonly performed and generally safe procedure, though procedural complexity and risk can vary based on clinical and procedural factors. Objective: This study aims to identify clinical and procedural factors associated with histologic evidence of subclinical vascular injury, defined by elastin positivity on extracted leads and its clinical significance. Methods: Patients undergoing TLE with a lead dwell time of ≥ 1 year were included. Extracted leads with tissue were analyzed histologically using Verhoeff-Van Gieson staining to assess the presence of elastin. Demographic data, procedural and lead characteristics, and indication for extraction were obtained. Established extraction risk scores were calculated to determine efficacy in predicting subclinical vascular injury. Results: The cohort included 49 patients with 92 leads extracted. A total of 25 patients (51%) had elastin-positive leads. Complete procedural success occurred in 95.9% of cases. The multivariate regression model did not identify any independent predictors of elastin presence, including age (OR = 1.00; 95% CI 0.95-1.05; p = 0.89), female gender (OR = 3.04; 95% CI 0.67-13.65; p = 0.14), lead dwell time (OR = 1.13; 95% CI 0.98-1.29; p = 0.07). Additionally, no scoring system, such as the CCF, EROS, MB, SAFeTY, and LECOM, predicted the presence of elastin. Conclusion: Subclinical venous injury was common following TLE, yet did not predict adverse clinical outcomes, reinforcing that TLE performed in experienced centers carries a favorable safety profile. Future studies in larger cohorts are needed to further characterize the clinical utility of subclinical vascular injury. (© 2026 Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: cardiac implantable electronic devices; elastin risk stratification; lead dwell time; pocket infections; transvenous lead extractions; vascular injury; vascular injuryvascular injuryvascular injury |
| Substance Nomenclature: | 9007-58-3 (Elastin) |
| Entry Date(s): | Date Created: 20260708 Date Completed: 20260915 Latest Revision: 20260917 |
| Update Code: | 20260917 |
| PubMed Central ID: | PMC13576558 |
| DOI: | 10.1111/jce.70402 |
| PMID: | 42418820 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1540-8167 |
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| DOI: | 10.1111/jce.70402 |