Laser-assisted lead extraction: the European experience

Aims The aim of this study is to investigate the safety and effectiveness of Excimer laser-assisted lead extraction in Europe. The final European multi-centre study experience is presented. Method and results The Excimer is a cool cutting laser (508C) with a wavelength of 308 nm. The energy is emitted from the tip of a flexible sheath and is absorbed by proteins and lipids, 64 % of the energy is absorbed at a tissue depth of 0.06 mm. The sheath is positioned over the lead, and the fibrosis surround-ing the lead is vaporized while advancing the sheath without damaging other leads. From August 1996 to March 2001, 383 leads (170 atrial, 213 ventricular) in 292 patients (mean age 61.6 years, range 13–96) were extracted at 14 European centres. Mean implantation time was 74 months (3–358). Most frequent indications were pocket infection (26%), non-functional leads (21%), patient morbidity (21%), septicae-mia or endocarditis (14%), erosion (5%), and lead interference (8%). Median extraction time was 15 min (1–300). Complete extraction was achieved in 90.9 % of the leads and partial extraction in 3.4%. Extrac-tion failed in 5.7 % of the leads. Major complications perforations caused 10/22 (3.4/5.7%) of the failures. Most partially extracted patients were considered clinically successful, as only minor lead parts without clinical significance were left. Femoral non-laser technique was used to remove 8/1