Preserving Access After Lead Extraction in Venous Stenosis Using Snaring: The Cowboy Bridge Technique

Arrhythmia & Electrophysiology Review 2026 Open access

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Authors: Elkin González Villegas, Panagiotis Mililis, Jesús Saldaña García, Alejandra Barreto, José Carlos Romero Carmona, Athanasios Saplaouras, Κonstantinos P. Letsas, Michael Efremidis, Rafael Peinado Peinado
DOI: 10.15420/aer.2025.57
Cited by: 0
References: 10

Abstract

Maintaining continuous access to the right heart chambers during lead extraction is essential, especially when venous stenosis is present. The Cowboy Bridge technique is a novel and reproducible approach that implies retrograde snaring from a femoral access. We report our results applying this technique in two patients with venous stenosis who required a device upgrade with lead extraction. This procedure facilitates the implantation of new leads by maintaining thorough-and-through access and lowering the risk of perforation compared to anterograde or retrograde attempts to traverse the stenotic site with additional wires or catheters.

Fields of Study & Subjects

Cardiac pacing and defibrillation studies Cardiac Arrhythmias and Treatments Coronary Interventions and Diagnostics

Publication details

Journal / source
Arrhythmia & Electrophysiology Review
Volume
15
Pages
e05–e05
Publication date
17 February 2026
Language
EN