Method and apparatus for removing an implanted pacemaker lead

摘要

Heart lead removal apparatus and method are disclosed for removing a pacemaker lead from a heart through a blood vessel leading thereto. The apparatus comprises a flexible stylet wire with an expandable wire coil attached to the distal end for engaging the coiled structure of the pacemaker lead. A lockable mechanism grasps the proximal end of the lead, and a wire guide is inserted in the passageway of the lead to determine its size and clear any blockage therein. The stylet wire is inserted in the longitudinal passageway of the coiled structure to the distal end of the pacemaker lead. The stylet wire is rotated in a direction to unwind and expand the wire coil and engage the coiled structure, thereby securing the stylet wire to the pacemaker lead. A tie secures the insulating material to the coiled structure of the lead at the proximal end thereof to limit motion and to apply a uniform extraction force to the entire lead. A separator tube is inserted over the proximal end of the stylet wire and the lead and moved along the entire length of the lead to first separate the restricted lead from the blood vessel and then the heart cavity. The separator tube, stylet wire, and pacemaker lead are then removed from the heart cavity and blood vessel without causing any significant injury to the heart cavity wall.