Endocardial lead extraction apparatus and method

摘要

A composite assembly includes a first catheter having a lead grasping mechanism extending through a channel thereof, a second catheter concentrically disposed over the first catheter and having a smooth, tapered end and a third catheter concentrically disposed over the second catheter and is used to remove an inoperative endocardial lead from a patient's heart through a venous path. A free end of the lead is grasped and held securely to the first catheter by a grasping mechanism. The second and third catheters then are slid as a unit through the venous path over the grasped end of the lead as opposing tensile force is maintained on the first catheter to prevent movement of the lead. The second catheter is rotated to cause its smooth, tapered, leading edge with outward sharp serrations to separate scar tissue from the lead and dilate a path through the scar tissue. The third catheter, which also has a smooth leading edge and outward sharp serrations is further advanced a predetermined amount forward over the second catheter and is rotated to separate and/or dislodge a tip of the lead which is embedded in scar tissue of the heart. The composite assembly along with the lead therein then is removed as a unit from the heart via the venous path without causing excessive forces to be applied to the vein or the wall of the heart.