INTRODUCTION: Venoplasty allows the addition or replacement of leads despite subtotal or total subclavian occlusion. METHODS: The threshold of the LV pacing lead implanted for biventricular pacing over a period of 18 months increased to greater than 5 V. A pre implant venogram revealed total subclavian occlusion. Venous access was maintained by extraction of the 4 F LV lead over a wire. Subsequently the sheath would not advance despite 6mm balloon inflation to 30 atm with no residual waist. A wire was placed beside the balloon and the balloon was reinflated. RESULTS: The subclavian obstruction was eliminated without damage to the existing leads. CONCLUSION: The obstruction formed by the fibrous track around an extracted lead may persist despite what appears to be successful balloon dilation. Inflation with a wire beside the balloon increases the effect eliminating the resistant obstruction without damaging the leads.
INTRODUCTION: Venoplasty allows the addition or replacement of leads despite subtotal or total subclavian occlusion. METHODS: The threshold of the LV pacing lead implanted for biventricular pacing over a period of 18 months increased to greater than 5 V. A pre implant venogram revealed total subclavian occlusion. Venous access was maintained by extraction of the 4 F LV lead over a wire. Subsequently the sheath would not advance despite 6mm balloon inflation to 30 atm with no residual waist. A wire was placed beside the balloon and the balloon was reinflated. RESULTS: The subclavian obstruction was eliminated without damage to the existing leads. CONCLUSION: The obstruction formed by the fibrous track around an extracted lead may persist despite what appears to be successful balloon dilation. Inflation with a wire beside the balloon increases the effect eliminating the resistant obstruction without damaging the leads.
Authors: David Meerkin; Seung H Lee; Fermin O Tio; Erberharde Grube; S Chiu Wong; Mun K Hong Journal: J Invasive Cardiol Date: 2005-04 Impact factor: 2.022
Authors: Craig J McCotter; J Fritz Angle; Liza A Prudente; J Paul Mounsey; John D Ferguson; John P DiMarco; James P Hummel; J Michael Mangrum Journal: Pacing Clin Electrophysiol Date: 2005-09 Impact factor: 1.976
Authors: Joseph Donnelly; James Gabriels; Andrew Galmer; Jonathan Willner; Stuart Beldner; Laurence M Epstein; Apoor Patel Journal: Curr Treat Options Cardiovasc Med Date: 2018-07-11