Ghostbusters should come back to lead extraction arena in order to fight with ghosts: Author's reply

We appreciate the interest of Dr Canpolat in our article.1,2 Persistence of residual fibrous tissue after transvenous lead extraction (TLE) has been described variously over the last few years.3–5 Focusing on pathophysiological mechanism for development of ‘ghost’, Andreaset al. described the histopathology of an inhomogeneous highly mobile structure in the right atrium after TLE, as organized thrombus in a case report.6 Immunohistochemical analysis of 17 extracted leads revealed that a fibrous capsule surrounding the lead was partially or completely covered with a monolayer of CD34 expressing endothelial cells.7 Endothelialization of the fibrous encapsulation indicates a functionalization of blood-contacting surfaces around leads, thus providing a mechanism for long-term persistence of foreign materials in the blood.7 On the other hand, granuloma tissue and vasculogenesis were present in the encapsulating tissue of 56 extracted leads, particularly in patients with device-endocarditis and pocket infection.8
Source: Europace - Category: Cardiology Source Type: research