Learn more about the perceived risk of procedure and identifying patients/getting them to the right center for treatment. Data shows that earlier device removal correlates with improved mortality rates and patient outcomes.
the guidelines are very clear on the recommendations. And again, there's this class one recommendation for extraction and complete hardware removal in patients that have a known device infection oftentimes what ends up happening is that it's perceived that the risk of extraction is high or that the procedure is is overly complex. And part of that is that not every center does extraction procedures. So not every center, not all the providers have access to it within their own institution and those that don't have access to it within their own institution or our institutions that maybe do lower volume or less of the procedure may have misperceptions of the riskiness of the procedure. And so I think that's one of the barriers. I think that getting these patients identified for the fact that that they need to have this procedure and getting into a center that's able to do it safely is really one of the things that we now need to focus on. I think that for many providers there's the hope that when you treat somebody with an antibiotic that the infection goes away, that's how infections work for most other infections in our body. Unfortunately, it's different when you have the pacemaker defibrillator in place. When the pacemaker defibrillator is in place, the risk of the infection returning is extremely high. The studies have shown that really up to 100% of patients will have recurrence of their infection. And so again, when you, when you sort of look across studies, it's somewhere between 50 and 100% of patients that have recurrence of their infection when you just treat with antibiotics alone. And so there is that hope that that maybe they'll their patient will be one of the lucky ones that can just clear the infection without having the device removed. And so because they may not have access to the procedure within their own institution or because of this misperception of the risk of the procedure. A lot of times providers will favor treating with antibiotics to see if the infection happens to clear the problem is again Between 50 and 100% of patients have recurrence of that infection and when they come back with that recurrent infection, they tend to be more ill. They tend to be have more systemic complications from the infection and they actually tend to do worse. And so one of the striking findings from the data, it was not only that extraction in these patients with infection improved mortality, but there was almost what we would call a dose response, meaning the earlier you get to remove the device, the better patients do in terms of mortality. And so there was actually Even improved mortality with extraction within a week relative to extraction from seven days out to 30 days or beyond. And so not only was extraction beneficial, but there was this dose response where earlier extraction provided incremental benefit. And so getting these devices out sooner Will improve mortality and improve patient outcomes. And so that's one of the reasons that we really want to try to get this as a first line therapy for the patients that have this guideline indication. And we don't want to go through rounds of antibiotics when we know the risk of failure of the antibiotics is going to be between 50 and 100%.
