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An increasing number of patients with cardiovascular implantable electronic devices leads to more complications requiring transvenous lead extraction (TLE) as part of treatment [1]. Indications for this procedure are: damaged leads or a device–related infection (presenting as lead endocarditis or isolated infection of the device pocket) [2]. According to current guidelines, TLE procedures are considered to be complicated and should be performed only by experienced operators at reference centers with a cardiac surgery team on standby. Despite the advanced tools used in lead extraction, such as laser sheaths or mechanical sets with rotating cutters, intraand immediate post-operative mortality from TLE still is noted0 [3-4]. Though relatively infrequent, the most dramatic complication is SVC or brachiocephalic vein damage, leading to massive bleeding into the mediastinum and often into the pleura. In such cases cardiosurgical intervention is the only life-saving treatment, though not always effective [4]. Citation

european journal of translational and clinical medicine

Transesophageal three-dimensional echocardiography improves the safety of transvenous extraction of pacemaker and implantable cardioverter-defibrillator leads – preliminary report