Abstract 2906: Effectiveness of New ICD Lead Coil Treatments in Facilitating Ease of Extraction
Expandable polytetrafluoroethylene (PTFE) coated and medical adhesive back-filled (MABF) implantable defibrillator (ICD) coils have been promoted to reduce the fibrous ingrowth into coils that can complicate lead extraction. We studied whether PTFE or MABF ICD leads are easier to extract than conventional leads, as measured by procedure and fluoroscopy times, radiation dose and lead fibrosis.
Methods: ICD lead extraction cases between 1/04 – 4/09 were retrospectively identified from a prospectively collected clinical database. To minimize confounders (e.g. multiple lead extractions, time required for reimplantation), only single ICD lead extractions without reimplantation were included. The most common indication for extraction was infection. Primary endpoints included total procedure (PT) and fluoroscopy (FT) times, radiation dose (RD) and fibrosis sites. Data were analyzed using univariate and multivariate analyses in total and propensity matched groups, which adjusted for lead age (older in the conventional group) and other factors.
Results: Among 329 patients meeting inclusion criteria (80% male; age 64±15yrs), PTFE and MABF leads were associated with lower PT, FT, RD and fibrosis (Tables⇓⇓). Only procedure time and brachiocephalic fibrosis remained significantly lower in propensity score matched groups. There were no differences between PTFE and MABF leads.
Conclusions: Extraction of PTFE and MABF ICD leads are associated with decreased total procedure times and brachiocephalic vein fibrosis compared to conventional leads.