[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-418122-105":59,"doc-detail-418122-en":135},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":128,"head_meta":130,"extra_data":132,"updated_unix":134},105,"en","pre-procedural-computed-tomography-predicts-procedural-complexity-and-complications-in-bidirectional-rotational-mechanical-transvenous-lead-extraction","Pre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction","","Despite technical advances, transvenous lead extraction (TLE) remains challenging and can cause serious complications. This retrospective study assessed whether pre-procedural contrast-enhanced computed tomography (CT) using a dedicated lead extraction protocol predicts complications and procedural complexity in patients undergoing rotational mechanical TLE as a first-line strategy. Among 115 patients, complicated procedures (20.9%) and complex procedures (37.4%) were independently associated with CT-derived fibrosis length and related calcification and clinical factors. CT supported individualized risk stratification for procedural planning.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pre-procedural-computed-tomography-predicts-procedural-complexity-and-complications-in-bidirectional-rotational-mechanical-transvenous-lead-extraction/418122/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pre-procedural-computed-tomography-predicts-procedural-complexity-and-complications-in-bidirectional-rotational-mechanical-transvenous-lead-extraction/418122.png","ImageObject",300,407,{"name":92,"@type":93},"Miles","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What was the aim of this study on rotational mechanical transvenous lead extraction?","Question",{"text":113,"@type":114},"To determine whether pre-procedural CT can predict complications and procedural complexity in patients undergoing rotational mechanical TLE as a first-line strategy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were complicated and complex procedures defined in the study?",{"text":118,"@type":114},"Complicated procedures included major complication, incomplete lead removal, or snare use; complex procedures required either a snare or a tissue stabilization sheath.",{"name":120,"@type":111,"acceptedAnswer":121},"Which CT findings predicted complicated procedures?",{"text":122,"@type":114},"Longest fibrosis length on CT independently predicted complicated procedures, with fibrosis length >40 mm showing strong predictive performance.",{"name":124,"@type":111,"acceptedAnswer":125},"What did the study conclude about CT use in procedural planning?",{"text":126,"@type":114},"Pre-procedural CT accurately identifies high-risk anatomical features, particularly fibrosis length and calcifications, and supports integrating imaging into planning and individualized risk stratification.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},418122,1790809929,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Europace (2025) 27, euaf308  \n [https://doi.org/10.1093/europace/euaf308](https://doi.org/10.1093/europace/euaf308)  \nCLINICAL RESEARCH  \nPre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction  \nFederico Migliore  1*†, Raimondo Pittorru  1†, Vincenzo Tarzia1, Jacopo Rosso1, Manuel De Lazzari  1, Andrea Ziggiotto1, Gaia Zancanaro1, Giulia Winnicki  1, Marco Gemelli  1,2, Matteo Micciolo1, Antonio Guerrieri3, Davide Margheri  3, Raffaella Motta  1, Valeria Pergola  1, Gino Gerosa  1, and  \nDomenico Corrado  1  \n1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, Padua 35121, Italy; 2Cardiothoracic Surgery, Bristol Heart Institute, University of Bristol, Bristol, UK; and 3Radiology Unit, University of Padua-Azienda Ospedaliera, Padua, Italy  \nReceived 9 September 2025; accepted after revision 26 November 2025; online publish-ahead-of-print 6 December 2025  \nAims Despite technical advances, transvenous lead extraction (TLE) remains a challenging procedure. Cardiac computed tomog  \nraphy (CT) has emerged as a valuable tool for pre-procedural assessment, but its role in predicting outcomes in rotational mechanical TLE as a first-line strategy is not well defined. The aim was to determine whether pre-procedural CT can predict complications and procedural complexity in patients undergoing rotational mechanical TLE.  \nMethods and results  \nThis retrospective study included 115 patients. All had pre-procedural contrast-enhanced CT with a dedicated lead extraction protocol. Two procedural outcomes were evaluated: (i) complicated procedure, defined as major complication, incomplete lead removal, or snare use, and (ii) complex procedure, defined as requiring either a snare or a tissue stabilization sheath. Logistic regression and receiver operating characteristic analyses were used to identify predictors. A total of 215 leads were extracted (mean dwelling time 95 ± 73 months) . Complicated procedures occurred in 20.9% and were independently associated with longest fibrosis length on CT (odds ratio 1.1; P \u003C 0.001); a fibrosis length of >40 mm predicted complicated procedures [area under the curve (AUC) 0.92; 95% confidence interval (CI) 0.88–0.97] . Complex procedures occurred in 37.4% and were associated with longest fibrosis length, lead calcification, dwelling time, and systolic heart failure. A fibrosis length of >30 mm predicted complex procedures (AUC 0.72; 95% CI 0.64–0.81) .  \nConclusion Pre-procedural CT allows accurate identification of high-risk anatomical features, particularly fibrosis length and calcifica  \ntions, which independently predict both complicated and complex rotational mechanical TLE. These findings support the integration of CT imaging into procedural planning and individualized risk stratification.  \n* Corresponding author. Tel: +39 049 8212479. E-mail address: [federico.migliore@unipd.it](federico.migliore@unipd.it)[ ](federico.migliore@unipd.it)† The first two authors are co-first authors.  \n© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution License ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.  \nGraphical Abstract  \nClinical application of computed tomography prior transvenous rotational mechanical lead extraction  \nIncrease risk of complicated procedure  \n Fibrosis length >40 mm at CT  \nL Lead  \nSVC  \nSensit ivity  \n1.0  \n0.8  \n0.6  \n0.4  \n0.2  \n0  \n1-specificity  \nIncrease risk of complex procedure  \n Fibrosis length >30 mm at CT  \n Calcifications at CT  \nStructured Pre-procedural CT protocol  \nTransvenous rotational mechanical ","cbCaisaYoq1EDFcs","https://ap.wps.com/l/cbCaisaYoq1EDFcs","pdf",1289123,"English","# Aims\n# Methods and results\n## Predictors for complicated procedures\n## Predictors for complex procedures\n# Conclusion\n# Graphical abstract\n# What’s new?\n# Introduction","[{\"question\":\"What was the aim of this study on rotational mechanical transvenous lead extraction?\",\"answer\":\"To determine whether pre-procedural CT can predict complications and procedural complexity in patients undergoing rotational mechanical TLE as a first-line strategy.\"},{\"question\":\"How were complicated and complex procedures defined in the study?\",\"answer\":\"Complicated procedures included major complication, incomplete lead removal, or snare use; complex procedures required either a snare or a tissue stabilization sheath.\"},{\"question\":\"Which CT findings predicted complicated procedures?\",\"answer\":\"Longest fibrosis length on CT independently predicted complicated procedures, with fibrosis length \\u003e40 mm showing strong predictive performance.\"},{\"question\":\"What did the study conclude about CT use in procedural planning?\",\"answer\":\"Pre-procedural CT accurately identifies high-risk anatomical features, particularly fibrosis length and calcifications, and supports integrating imaging into planning and individualized risk stratification.\"}]","Pre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction | PDF",1790612054,25]