Anchoring The Lead; Tunneling The Percutaneous Extension - Medtronic PISCES QUAD 3487A Manual Del Usuario

3487ALead_CH.fm 5/13/04 3:14 pm
UC200xxxxxx EN
4 x 8 inches (101 mm x 203 mm)

Anchoring the lead

Caution: Do not tie ligatures around the lead or extension body, which
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may damage the insulation.
1. Prepare the anchor site by making a 5 – 7 cm (2.0 – 2.8 in) longitudinal
incision around the needle shaft, dissecting down to the supraspinous
ligament, and establishing hemostasis.
2. Disconnect the stylet from the lead. Partially expose, but do not completely
withdraw the stylet.
3. While maintaining lead position, use minimal force to remove the needle
and stylet.
Caution: Use minimal traction to remove the needle because quick
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or sudden removal may dislodge the lead.
4. Slide the anchor onto the proximal end of the lead and continue sliding the
anchor down as close as possible to where the lead emerges from the
vertebral column. Use care to maintain the lead position.
Notes:
■ The anchor can be lubricated with sterile water.
■ For a twist-lock anchor, ensure that the anchor is unlocked before
sliding the anchor onto the lead. (An unlocked anchor is twisted so the
two parts are at a 90° angle to each other.)
5. Use 2-0 nonabsorbable suture (such as silk or some types of braided
polyester mesh) to secure the anchor.
Cautions:
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■ Do not use polypropylene suture material on silicone
components. Polypropylene may damage the component,
resulting in component damage or failure.
Do not overtighten ligatures on the anchor or connector boot.
■
Ligatures that are too tight may damage the component.
For the twist-lock anchor: Suture the anchor to the supraspinous
ligament or deep fascia. Next, lock the anchor to secure the lead.
Note: If minor repositioning is necessary, unlock the lead, then relock the
anchor.
For the winged anchor: Tie ligatures around the grooves in the middle of
the anchor to secure the anchor to the lead. Next, suture the anchor to the
supraspinous ligament or deep fascia.
Note: Laboratory testing has shown that injecting silicone medical
adhesive between the anchor and lead after tying the ligatures increases
the anchor-to-lead holding force.
6. Verify test stimulation parameters to ensure that the lead has not moved:
connect the short stylet handle to the lead, connect the screener cable to
the lead, then, connect the screener cable plug to the screener. If the lead
has moved, reposition it.

Tunneling the percutaneous extension

1. After simulating the tunneling route, mark the patient's skin at the lead-
extension connection site and at the percutaneous extension exit site (exit
site). The exit site should be on the side opposite that intended for the
neurostimulator and at least 10 cm (4 in) lateral. (The neurostimulator
should be placed on the opposite side of the body from another active
implanted device and should be placed preferably on the right side of the
body to allow for future placement of cardiac devices on the patient's left
side.)
10 English 3487A, 3887, 3888 2004-05
198855002 Rev A
Medtronic Confidential
NeuroLdExt_R01