# Evolution‐Guided Unidirectional Counter‐Clockwise Rotation for Nonretractable Screw‐in Lead Removal **Authors:** Masatsugu Nozoe, Takafumi Sakamoto, Satoshi Tsujioka, Daisuke Nagatomo, Nobuhiro Suematsu, Toru Kubota PMC · DOI: 10.1002/joa3.70300 · Journal of Arrhythmia · 2026-02-16 ## TL;DR A new technique using a special sheath helps safely remove heart leads with less risk of injury. ## Contribution A novel technique for nonretractable screw-in lead removal using controlled rotation with the Evolution RL sheath. ## Key findings - Unidirectional counter-clockwise manipulation enables controlled lead body rotation. - The technique may reduce myocardial injury during lead removal. ## Abstract Unidirectional counter‐clockwise manipulation of the Evolution RL sheath after adequate dissection enables controlled lead body rotation and gradual unscrewing. This technique may reduce myocardial injury during non‐retractable screw‐in lead removal. ## Full-text entities - **Diseases:** myocardial injury (MESH:D009202), cardiac injury (MESH:D006331), pericardial effusion (MESH:D010490), atrial lead damage (MESH:D020263), myocardial perforation (MESH:D012167), Brugada syndrome (MESH:D053840), adhesion (MESH:D000267) - **Chemicals:** implantable (-) - **Species:** Homo sapiens (human, species) [taxon 9606] ## Full text _Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12910129/full.md ## Figures 6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12910129/full.md ## References 3 references — full list in the complete paper: https://tomesphere.com/paper/PMC12910129/full.md --- Source: https://tomesphere.com/paper/PMC12910129