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In order to minimize the risk of removing the leads, special techniques have been developed for lead removal. Special tools are used to anchor the lead using the narrow channel within the lead called the lumen. Anchoring the lead from near its tip from within the lead allows the pulling forces to maximize the ability to remove the lead and minimize the ability for the lead to be pulled apart during the removal process. In cases in which the leads cannot be removed with traction (pulling) alone, a special laser device is used to destroy the fibrous tissue surrounding the lead. Special care is taken to only destroy the fibrous tissue needed for the removal of the lead without damaging the heart or the surrounding blood vessels.
The most serious risk of lead extraction is the damage or tear in the heart or blood vessels, which may be life-threatening because it may result in rapid collapse and may require emergency open chest heart surgery and may result in death.