Background: Removal of infected endovascular leads has often required for cure of systemic infection, but the perceived risk of embolic in the presence of large (> 10 mm) vegetations has been considered a relative contraindication to transvenous removal.
Methods: Between 2005 and 2012, 119 patients who extracted due to infection (256 leads) were enrolled in this study. The primary endpoint of this study was incidence of pulmonary embolism (PE) after procedure in patients with and without large vegetation. The secondary endpoints were major adverse events and hospitalization period in each group.
Results: Large vegetation (range 12-25mm) was found in 9 (15.1%) patients. All patients underwent successful transvenous removal of endocardial leads. In entire group, two patients had developed PE (11.1% vs 0%, p=0.005). There was no difference in hospitalization periods and MAEs between those with or without large vegetation (47.8±21.3 days vs 37.9±26.1 days, P value 0.13) (22.2% vs 7.92% , P value 0.09).
Conclusions: Incidence of PE after procedure was significantly higher in patients with large vegetation. However, no significant difference of MAE and hospital stay was found.