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Vacuum-assisted vegetation removal with percutaneous lead extraction: a systematic review of the literature

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

To perform a systematic review of reports in which the AngioVac™ percutaneous vacuum-assisted aspiration system was successfully used to debulk or remove vegetations prior to percutaneous lead extraction.

Methods

We included all studies and case reports that used a percutaneous aspiration technique for vegetation removal or debulking with percutaneous lead extraction for patients with lead-associated endocarditis. Ten reports and retrospective data from our centers were used, which included a total of 88 patients and 205 leads.

Results

The percutaneous aspiration procedure was completely or partially successful in 86 patients (97.7%). The lead extraction procedure itself was successful in 87 patients (98.9%). The aspiration procedure and lead extraction were done concomitantly in 81 patients (92.0%). Four patients (4.5%) had major complications (two due to vascular injuries, one due to coronary sinus injury, and one due to tricuspid valve injury). There were no complications from the aspiration procedure, and no cases were associated with procedure-related mortality.

Conclusion

While patients with large vegetations have historically been referred for surgical lead extraction, data are lacking in its techniques and outcomes. Existing data suggest that percutaneous vacuum-assisted aspiration for vegetation removal or debulking in endocarditis prior to or concurrent with percutaneous lead extraction has a high success rate with a low complication rate across a broad series of patients.

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Authors and Affiliations

  1. Division of Cardiology, Clinical Cardiac Electrophysiology, Keck School of Medicine of USC, 1510 San Pablo Street, Suite 320, Los Angeles, CA, 90033, USA

    Akash Rusia, Audrey J. Shi & Rahul N. Doshi

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  1. Akash Rusia
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  2. Audrey J. Shi
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  3. Rahul N. Doshi
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Correspondence to Rahul N. Doshi.

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The authors declare that they have no conflicts of interest.

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Rusia, A., Shi, A.J. & Doshi, R.N. Vacuum-assisted vegetation removal with percutaneous lead extraction: a systematic review of the literature. J Interv Card Electrophysiol 55, 129–135 (2019). https://doi.org/10.1007/s10840-019-00555-6

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  • DOI: https://doi.org/10.1007/s10840-019-00555-6

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