A lead extraction procedure commenced to remove a right atrial (ra) and a right ventricular (rv) lead due to cied system/pocket infection.Spectranetics lead locking devices were inserted into each lead (near or at distal tip of each lead) to provide traction.A spectranetics 13f tightrail rotating dilator sheath was used to attempt removal of the rv lead, and a spectranetics 14f glidelight laser sheath along with a spectranetics visisheath dilator sheath was used for the ra lead.During the procedure, both leads stretched while significant traction was being applied with use of the llds, and they broke near the clavicle area (mdr #1721279-2022-00088 for rv).Due to the stretching of the leads, the llds had nothing to lock onto within the leads, and they slipped out of each lead, along with the proximal lead portions.There were 3 physicians in the room, so they planned to snare each lead from different femoral access points: the ra lead was successfully snared from a right femoral access using a cook medical needle's eye snare with no complications, and a snaring attempt to remove the rv lead was performed from a left femoral access using an argon medical atrieve vascular snare.The left femoral sheath wasn't large enough, so the ct surgeon peeled the sheath and reached in with a clamp to pull out the atrieve snare and rv lead remnant.The left femoral vein was damaged by this and bleeding was uncontrolled, so the ct surgeon surgically cut down the vein and repaired the left leg.The procedure was completed and the patient survived the procedure.This report captures the lld providing traction within the ra lead when the lead broke, requiring intervention to remove the lead remnant.There was no alleged malfunction of any spectranetics devices in use during the procedure.The injury to the left femoral vein occurred when the physician used the clamp to pull out the atrieve snare and rv lead remnant, and was unrelated to any spectranetics devices.
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