MEDNOVO's Proprietary Trio of Medical Devices Enables Successful Cardiac Lead Extraction

Patient: Female, 81 years old.2008: Underwent CRTD implantation at a local hospital due to dilated cardiomyopathy and cardiac insufficiency.;July 2024: Underwent generator replacement and lead revision due to premature battery depletion.;Early July 2025: Hospitalized after discovery of CRTD pocket erosion with evident purulent discharge.Angiography during hospitalization revealed left subclavian vein occlusion and CRTD pocket erosion with significant pus formation.

pacemaker exposure and pocket erosion

After comprehensive evaluation, Dr. Pan Xiaohong's team concluded that due to multiple factors including pacemaker exposure and pocket erosion, early extraction of the 1 ICD defibrillation lead and 3 solid electrode leads was necessary to minimize infection risk and relieve venous obstruction at minimal cost.

pre-operation

Imaging findings suggest subclavian vein occlusion

Given the patient’s advanced age and the prolonged duration of pacemaker lead implantation, the leads are likely heavily adhered to the vascular wall and myocardial tissue. Attempting extraction using conventional tools or manual traction would not only pose significant surgical challenges but also increase patient risk.

After evaluation, Dr. Pan Xiaohong’s team decided on the following approach：Utilize Mednovo’s proprietary mechanical dilation sheath combined with a locking stylet to first extract the defibrillation lead. Subsequently, employ an endovascular snare to simultaneously capture and remove the three solid electrode leads.

During the procedure, Dr. Pan Xiaohong’s team Secured the defibrillation lead using a locking stylet, Advanced an 11F mechanical dilation sheath along the defibrillation lead to dissect the adherent tissue, Successfully extracted the right ventricular defibrillation electrode lead.

extraction of ICD lead using mechanical dilation sheath

Subsequently, via right femoral vein puncture, the three solid electrode leads were successfully captured and extracted using an endovascular snare. The procedure was completed smoothly, and the patient was returned to the ward in stable condition.

During operation

Dr. Pan Xiaohong, the lead surgeon, commented：

• The blunt tip design of the mechanical dilation sheath’s inner tube ensures high cutting efficiency while maintaining safety. When dissecting adherent tissue along the subclavian to superior vena cava segment, the sheath was flexed to nearly 90 degrees yet remained intact without kinking upon withdrawal, demonstrating excellent flexibility and toughness.

• The nitinol loop of the endovascular snare provided exceptional visibility under imaging and exhibited high adaptability.

Dr. Pan Xiaohong, the lead surgeon, shared the following insights：

The mechanical dilation sheath demonstrates superior tissue-separating efficacy in cases of severe adhesions. For entangled multiple leads, the superior approach (via SVC) can first be used to dissect and extract the leads. If challenges persist, the inferior approach (via IVC) may then be employed to capture and remove residual leads.

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「Mechanical Dilation Sheath」Designed for transvenous removal of fibrotic tissue surrounding cardiac leads to facilitate lead extraction procedures.

「Locking Stylet」The locking stylet achieves secure fixation when engaged with hollow electrode leads, enabling: Direct lead extraction, Combined use with mechanical dilation sheaths for complex cases.