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The monorail sistering technique: Use of a directable decapolar catheter to support a fragile lead fragment for extraction—A first experience and feasibility case report

Dikdan, Sean J.
; 
Brogan, Linda J.
; 
Cooper, Joshua M.
; 
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Genre
Journal article
Date
2025-08
Advisor
Committee member
Group
Temple University. Hospital
Department
Medicine
Subject
Lead extraction
 Lead management
 Tensile strength
 Femoral snare
 ICD
 Pacemaker
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https://scholarshare.temple.edu/handle/20.500.12613/11384
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Open Access Publishing Fund
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DikdanEtAl-JournalArticle-2025-08.pdf
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DOI
https://doi.org/10.1016/j.hrcr.2025.05.027
Abstract
Key Teaching Points • Transected or distally fractured leads may be more fragile and limit the traction and counter-traction that can be safely applied to the lead, making successful complete extraction more challenging or even impossible. • Certain leads, specifically those with poor tensile strength, are more likely to require alternative tools and techniques to maintain their integrity while applying the force necessary for extraction using laser or mechanical sheaths. • Monorail sistering is a new technique where a decapolar catheter is passed from a femoral approach alongside the target lead, allowing the decapolar catheter and lead to be snared as a unit from above, and enabling the limits of traction and counter-traction forces to be based on the tensile strength of the decapolar catheter, and no longer the fragile lead.
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Citation
Sean J. Dikdan, Linda J. Brogan, Joshua M. Cooper, Isaac R. Whitman, The monorail sistering technique: Use of a directable decapolar catheter to support a fragile lead fragment for extraction: A first experience and feasibility case report, HeartRhythm Case Reports, Volume 11, Issue 8, 2025, Pages 816-819, ISSN 2214-0271, https://doi.org/10.1016/j.hrcr.2025.05.027. (https://www.sciencedirect.com/science/article/pii/S2214027125001599)
Citation to related work
Elsevier
Has part
HeartRhythm Case Reports, Vol. 11, Iss. 8
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