Table 3.
System related, pacing related and procedure related risk factors of major TLE complications and procedure complexity in different implant duration groups.
| System-Related Risk Factors of TLE Complexity and Major Complications | Leads under 10 Years | Leads 10–20 Years | Leads 20–30 Years | Leads over 30 Years | Statistic | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of patients/group number | 2524 | 1 | 926 | 2 | 190 | 3 | 33 | 4 | 2 vs. 1 | 3 vs. 1 | 4 vs. 1 |
| Form of results presentation | Count/aver. | %/Sd | Count/aver. | %/Sd | Count/aver. | %/Sd | Count/aver. | %/Sd | |||
| System and history of pacing | |||||||||||
| Pacemaker | 1595 | 63.19% | 797 | 86.07% | 182 | 95.79% | 33 | 100.0% | p < 0.001 | p < 0.001 | p < 0.001 |
| ICD | 691 | 27.38% | 111 | 11.99% | 6 | 3.16% | 0 | 0.00% | p < 0.001 | p < 0.001 | p < 0.001 |
| CRT-D | 238 | 9.43% | 18 | 1.94% | 2 | 1.05% | 9 | 0.00% | p < 0.001 | p < 0.001 | 0.001 |
| Number of leads in the heart before TLE | 1.91 | 0.70 | 2.01 | 0.80 | 2.18 | 0.90 | 2.27 | 0.88 | 0.001 | p < 0.001 | 0.004 |
| ≥4 leads in the heart | 51 | 2.02% | 44 | 4.75% | 19 | 10.00% | 3 | 9.09% | p < 0.001 | p < 0.001 | 0.031 |
| Number of procedures before TLE | 1.51 | 0.80 | 2.49 | 1.05 | 3.38 | 1.29 | 4.07 | 1.46 | p < 0.001 | p < 0.001 | p < 0.001 |
| TLE procedure related potential risk factors of major TLE complications and procedure complexity | |||||||||||
| ICD lead extraction | 870 | 34.47% | 126 | 13.61% | 9 | 4.74% | 0 | 0.00% | p < 0.001 | p < 0.001 | p < 0.001 |
| CS lead extraction | 211 | 8.36% | 22 | 2.38% | 2 | 1.05% | 0 | 0.00% | p < 0.001 | p < 0.001 | 0.107 |
| Number of extracted leads in one patient | 1.56 | 0.68 | 1.82 | 0.78 | 1.99 | 0.83 | 2.12 | 0.76 | p < 0.001 | p < 0.001 | p < 0.001 |
| Three or more leads were extracted | 215 | 8.52% | 125 | 13.50% | 39 | 20.53% | 10 | 30.30% | p < 0.001 | p < 0.001 | p < 0.001 |
| Utilised approach other than lead venous entry | 41 | 1.62% | 52 | 5.62% | 11 | 5.58% | 2 | 6.06% | p < 0.001 | p < 0.001 | 0.105 |
| Extraction of abandoned lead(s) (any) | 136 | 5.39% | 163 | 17.60% | 64 | 33.86% | 15 | 45.46% | p < 0.001 | p < 0.001 | p < 0.001 |
| Oldest extracted lead body dwelling time in the patient | 49.44 | 32.20 | 164.1 | 33.81 | 277.2 | 31.98 | 392.5 | 30.26 | p < 0.001 | p < 0.001 | p < 0.001 |
| Cumulative dwell time of extracted lead (in years) in the patient | 7.64 | 5.52 | 23.19 | 9.85 | 40.64 | 15.36 | 53.12 | 18.74 | p < 0.001 | p < 0.001 | p < 0.001 |
| Oldest extracted atrial lead dwell time | 60.77 | 32.33 | 158.6 | 41.56 | 255.8 | 53.83 | 261.9 | 108.8 | p < 0.001 | p < 0.001 | p < 0.001 |
| Oldest extracted ventricular lead dwell time | 58.20 | 32.15 | 157.1 | 39.62 | 267.5 | 47.66 | 385.1 | 56.27 | p < 0.001 | p < 0.001 | p < 0.001 |
| Risk of major complications (%) evaluated using SAFETY TLE calculator | 0.69 | 0.93 | 3.36 | 3.33 | 7.41 | 6.71 | 9.88 | 8.29 | p < 0.001 | p < 0.001 | p < 0.001 |
| TLE complexity and outcomes | |||||||||||
| Procedure duration (sheath to sheath) | 10.46 | 14.52 | 22.33 | 30.57 | 35.61 | 37.77 | 39.03 | 30.60 | p < 0.001 | p < 0.001 | p < 0.001 |
| Average time of single lead extraction | 6.81 | 8.96 | 12.34 | 16.46 | 18.31 | 18.33 | 18.30 | 12.92 | p < 0.001 | p < 0.001 | p < 0.001 |
| Technical problem during TLE (any) * | 361 | 14.30% | 311 | 33.59% | 91 | 47.90% | 18 | 54.55% | p < 0.001 | p < 0.001 | p < 0.001 |
| Necessity to utilise venous approach other than lead venous entry | 41 | 1.62% | 62 | 6.70% | 16 | 8.42% | 4 | 12.12% | p < 0.001 | p < 0.001 | 0.002 |
| Mutual lead to lead fusion with strong scar | 99 | 3.92% | 93 | 10.04% | 40 | 21.05% | 8 | 24.24% | p < 0.001 | p < 0.001 | p < 0.001 |
| Break of extracted lead | 35 | 1.39% | 70 | 7.56% | 28 | 14.74% | 7 | 21.21% | p < 0.001 | p < 0.001 | p < 0.001 |
| Byrd’s dilator collapse/detorsion | 53 | 2.10% | 51 | 5.51% | 16 | 8.42% | 5 | 15.15% | p < 0.001 | p < 0.001 | 0.001 |
| Block in venous lead entry region | 133 | 5.27% | 100 | 10.80% | 48 | 25.26% | 9 | 27.27% | p < 0.001 | p < 0.001 | p < 0.001 |
| Two or more technical problems | 55 | 2.18% | 68 | 7.34% | 35 | 18.42% | 10 | 30.30% | p < 0.001 | p < 0.001 | p < 0.001 |
| Utility of additional tools | |||||||||||
| Evolution (old and new) or TighRail | 16 | 0.63% | 24 | 2.59% | 14 | 7.37% | 0 | 0.00% | p < 0.001 | p < 0.001 | 1.000 |
| Metal sheath | 136 | 5.39% | 101 | 10.91% | 48 | 25.26% | 9 | 27.27% | p < 0.001 | p < 0.001 | p < 0.001 |
| Lasso catheter/snare or basket catheter | 52 | 2.06% | 89 | 9.61% | 30 | 15.79% | 7 | 21.21% | p < 0.001 | p < 0.001 | p < 0.001 |
| Temporary pacing during procedure | 207 | 8.20% | 147 | 15.87% | 47 | 24.74% | 11 | 33.33% | p < 0.001 | p < 0.001 | p < 0.001 |
* situation which increase procedure complexity but not being a complication.