Apparatus and method for separation of scar tissue in venous pathway

A method for passing a lead extraction apparatus over an endocardial lead extending through a venous path and surrounded by scar tissue that impedes advancement of said lead extraction apparatus through said venous path, said method comprising the steps of:

• (a) using a lead grasping device to grasp a portion of the endocardial lead and secure it to the lead grasping device;
• (b) providing a cannula concentrically disposed about said lead grasping device, and a first catheter having a distal end portion connected to a proximal end of said cannula and a proximal portion controllable from outside of said venous path, said cannula having locking means for engaging said endocardial lead, to lock said cannula to said endocardial lead, and providing a shearing cylinder having a distal end portion with a plurality of pointed teeth on said distal end portion, said second catheter being concentrically disposed about said first catheter, and providing a second catheter having a distal end connected to a proximal end of said shearing cylinderd and a proximal portion controllable from outside of said venous path;
• (c) advancing said cannula concentrically over said endocardial lead into said venous path, while using said lead grasping device to maintain tension on said endocardial lead and manipulating the proximal portion of said first catheter to advance it into said venous path into the scar tissue or obstruction so that the distal end of said cannula extends a predetermined distance into said scar tissue;
• (d) advancing said shearing cylinder along said cannula to cause the teeth of said second catheter to cut into said scar tissue and thereby separate said scar tissue to open a path that allows further advancement of said cannula and said shearing cylinder into said venous path;
• (e) repeating steps (c) and (d) until said cannula and said shearing cylinder have been advanced entirely through said scar tissue;
• and
• (f) withdrawing said shearing cylinder from said venous path, removing it from said lead grasping apparatus, slipping a third catheter over said first catheter, advancing said cannula and said third catheter toward a tip of said endocardial lead lodged in the heart to which said venous path leads to effectuate extraction of said embedded tip.