Laser extraction of entrapped leads

Removing entrapped pacing and defibrillator leads has been greatly simplifi ed by making use of the excimer laser extractor. Sixty-two leads were succe ssfully removed, although where appropriate, portions of the lead remained in place in 10 cases. There were two serious complications, one tear of the superior vena cava during an ICD extraction and one tear of the atrium dur ing an atrial lead extraction. Both were controlled successfully through em ergency sternotomy, Although extracting entrapped leads has been much simpl ified by making use of the laser extractor, the process is not free of seri ous complications. Those involved in explanting leads should be aware of th e outcomes and be prepared for emergent management.