Percutaneous lead extractions are probably the most difficult and challenging interventions of cardiac implantable electronic device (CIED) therapy. They encompass a heterogeneous patient clientele with different rhythm implants, complaints, infection localizations and indications as well as different primary and accompanying diseases. For this reason, the necessary methods of treatment, the required tools, as well as requirements for the surgeon and institutional infrastructure, vary considerably. This article provides an up-to-date overview concerning the facts and figures of German device therapy, as well as available tools for percutaneous lead extraction and salvage of intracorporeally abandoned lead fragments. Furthermore, options for lead vegetation removal, possibilities and tools for appropriate complication management as well as approaches for patients requiring ongoing cardiac stimulation and possible methods of wound treatment are presented and elucidated.