We report the case of a 50 year-old woman referred for extraction of an infected biventricular implantable cardioverter defibrillator (ICD) who underwent device and leads extraction. Due to adhesions at the level of the subclavian-innominate vein angle, manual traction with locking stylet was ineffective. A new mechanical sheath provided with a stainless steel bladed tip, the Evolution™ Mechanical Dilator Sheath (Cook Medical), was successfully used to complete lead extraction. As far as we know, this is the first report on the use of this new tool; its safety should be ascertained by increasing the number of cases but its simple use and its low cost make the Evolution™ Mechanical Dilator Sheath a new interesting tool that can be added to the instruments available for lead extraction. © 2008 Springer Science+Business Media, LLC.
Lead extraction: A new effective tool to overcome fibrous binding sites / Dello Russo, A.; Biddau, R.; Pelargonio, G.; Casella, M.; Frontera, A.; Camporeale, A.; Bisceglia, C.; Forleo, G. B.; Tondo, C.; Zecchi, P.; Bellocci, F.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1383-875X. - 24:2(2009), pp. 147-150. [10.1007/s10840-008-9326-y]