[Outcome of patients with local complications at the site of an implantable device].

Objective: The recommendations for complete lead extraction because of local complications at the site of implantable devices have changed in the last 10 years. We analyze the outcome of patients who required an intervention because of a local complication between 2002 and 2010, in our Hospital.
Methods: We retrospectively studied 83 patients with a local complication that was classified according to skin integrity: 1. Integrity, and 2. Open skin. We analyzed the type of intervention: 1. Conservative approach, 2. Incomplete extraction, 3. Complete extraction. The endpoints were the needing a later intervention and a complete removal during follow up.
Results: The group of patients with complete system extraction showed a lower rate of re-intervention during an average follow up of 1000 days, when compared to other two groups (6.7% vs. 57.7 and 43.8%, P<.01). Incomplete extraction and conservative approach had a similar outcome, needing a complete extraction 25% and 37.5%, respectively. The skin integrity did not seem to be relevant for outcome in these two groups. An 8.4% incidence of endocarditis was observed; all of them had a previous history of incomplete extraction or conservative approach.
Conclusions: Local complications treated with either a conservative approach or incomplete extraction are associated with a high rate of re-interventions, regardless of skin integrity, frequently needing final complete extraction and are associated to endocarditis.
(Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.)