Single center experience with a novel short rotating dilator sheath in transvenous lead extraction

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: Transvenous lead extraction has become a frequent procedure in the context of device lead management and various tools are available. The aim of this study was to investigate the efficacy and safety of the novel short rotating dilator sheath TightRailTM Sub-C (Sub-C) designed to facilitate vessel entry in the beginning of a transvenous lead extraction procedure necessitating active mechanical extraction tools. METHODS: For this retrospective single center analysis, we included consecutive patients undergoing transvenous lead extraction using the Sub-C from January 2018 until February 2020 at a university heart center. RESULTS: A total of 87 leads were extracted within 45 patients using the Sub-C extraction sheath. The mean dwell time of the leads was 112 ± 9.1 months. Complete procedural success was achieved in 95.6% (43/45) and clinical procedural success in 97.8% (44/45). Two major complications (4.4%, 2/45, 1 device pocket bleeding, 1 hemothorax) occurred, but neither were directly related to the Sub-C. CONCLUSION: The TightRailTM Sub-C appears to be a safe and efficient short rotating dilator sheath for achieving vessel entry in the beginning of a transvenous lead extraction procedure. [Figure: see text] [Figure: see text]