Table 3.
Detailed analysis of the risk factors associated with the procedure in terms of the complexity of the procedure and major complications.
| System and procedure information | Implantation ages 19–29 | Implantation and TLE ages 40–80 | A vs. B | ||
|---|---|---|---|---|---|
| A | B | Mann–Whitney U test, Chi2 P |
|||
| Number of patients | 126 | 2659 | |||
| Data for analysis | Count/average | %/SD | Count/average | %/SD | |
| Potential risk factors for major complications and technical problems | |||||
| Number of extracted leads per patient | 1.74 | 0.87 | 1.67 | 0.77 | P = 0.384 |
| Need to use alternative approach | 5 | 3.97% | 84 | 3.16% | P = 0.806 |
| Extraction of VDD lead | 13 | 10.32% | 64 | 2.41% | P < 0.001 |
| Extraction of lead with too long loop | 7 | 5.56% | 94 | 3.54% | P = 0.387 |
| Extraction of broken lead with too long loop | 2 | 1.50% | 67 | 0.00% | P = 0.715 |
| Extraction of abandoned lead(s) (any) | 17 | 13.49% | 288 | 10.83% | P = 0.043 |
| HV therapy (ICD) lead was extracted | 38 | 30.16% | 788 | 29.64% | P = 0.979 |
| CS (LV pacing) lead was extracted | 0 | 0.00% | 185 | 6.96% | P = 0.004 |
| Cumulative dwell times of extracted leads (in years) | 22.60 | 16.90 | 13.16 | 12.57 | P < 0.001 |
| SAFETY TLE risk score (number of points) | 8.70 | 5.00 | 5.65 | 4.21 | P < 0.001 |
| TLE procedure duration | |||||
| Procedure duration (skin to skin) (minutes) | 66.90 | 35.46 | 60.18 | 25.87 | P = 0.013 |
| Procedure duration (sheath to sheath) (minutes) | 22.27 | 32.77 | 14.81 | 22.75 | P < 0.001 |
| Mean extraction time per lead (sheath-to sheath/number of extracted leads) (minutes) | 14.10 | 26.60 | 8.65 | 12.24 | P < 0.001 |
| Procedure difficulty | |||||
| Technical problem during TLE (any) | 43 | 34.13% | 521 | 19.59% | P < 0.001 |
| Lead-to-lead binding | 12 | 9.52% | 181 | 6.81% | P = 0.320 |
| Byrd dilator collapse/torsion/"fracture" | 14 | 11.11% | 77 | 2.90% | P < 0.001 |
| Extracted lead fracture/rupture during extraction | 18 | 14.29% | 150 | 5.64% | P < 0.001 |
| Loss of free lead fragment | 1 | 0.79% | 13 | 0.49% | P = 0.864 |
| One technical problem only | 27 | 21.43% | 304 | 11.43% | P < 0.001 |
| Two technical problems | 11 | 8.73% | 74 | 2.78% | P < 0.001 |
| Need to use alternative approach | 18 | 14.329% | 43 | 1.62% | P < 0.001 |
| Use of additional tools | |||||
| Evolution (old and new) or TightRail sheaths | 3 | 2.38% | 30 | 1.13% | P = 0.396 |
| Metal sheaths | 9 | 7.14% | 183 | 6.88% | P = 0.947 |
| Lasso catheter/snare | 15 | 11.90% | 86 | 3.23% | P < 0.001 |
| Loop formed with catheter guide wire and lasso | 3 | 2.38% | 47 | 1.77% | P = 0.870 |
| Temporary pacing during procedure | 21 | 16.70% | 267 | 10.04% | P = 0.025 |
CS coronary sinus, HV high voltage, ICD implantable cardioverter defibrillator, LV left ventricle, TLE transvenous lead extraction.