Large laser sheaths for pacing and defibrillator lead removal

✍ Scribed by Reiser, Christopher; Taylor, Kevin D.; Lippincott, Rebecca A.

• Book ID: 101217728
• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 84 KB
• Volume: 22
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/(sici)1096-9101(1998)22:1<42::aid-lsm10>3.0.co;2-a

✦ Synopsis

Background and objective:

In a recent clinical trial, the 12-f laser sheath showed 95% success in completely explanting chronically implanted pacing leads smaller than 7.5-f diameter. for larger leads, two new sizes of laser sheath have been implemented, the 14-f and 16-f (outer diameter) devices, which accommodate leads up to 9.5- and 11.5-f, respectively. the object of this study was to determine the cutting ability of the larger devices compared to the 12-f design.

Materials and methods:

The rate of device advancement through fresh porcine aorta was measured for three sizes of laser sheath as pulsed ultraviolet light from a 308-nm xecl excimer laser was applied. dependent variables were fluence (mj/mm2), laser pulse repetition rate, and pressure applied between the device and the tissue.

Results:

At 60 mj/mm2, 40 hz repetition rate and 1.4 kg/cm2 pressure, all devices produced cutting rates in the range of 9-13 microns/pulse. improvement in advancement per laser shot can be attained by increasing any independent variable studied.

Conclusions:

Physicians must apply only slightly greater force to the larger laser sheaths, and maximum available repetition rate and fluence implies maximum cutting speed.