Powered sheaths for lead extraction.

Bencardino, Gianluigi; Ruscio, Eleonora; Scacciavillani, Roberto

Transvenous lead extraction (TLE) has seen a rapid expansion in the past 20 years. Procedure has changed from early techniques involving simple manual traction that frequently proved themselves ineffective for chronically implanted leads, and carried a significant periprocedural risks including death, to availability of a wide range of more efficacious techniques and tools, providing the skilled extractor with a well-equipped armamentarium. The reduction in morbidity and mortality associated with these new extraction techniques have widened indications to TLE from prevalent use in life-threatening situations, such as infection and sepsis, to a more widespread use even in non infectious situations like malfunctioning leads. Powered sheaths have been a remarkable step forward in this improvement in TLE procedures and recent registries at high-volume centers report high success rates with exceedingly low complication rates. This review is aimed at describing technical features of powered sheaths as well as reported performance during TLE procedures. This article is protected by copyright. All rights reserved.