Subclavian balloon venoplasty to facilitate lead implant in patient with subclavian venous obstruction.

Implanting new leads for defibrillation or pacing leads could be problematic as a result of venous obstruction. Up to 50% of patients with pacemaker/implantable cardioverter defibrillator leads have an asymptomatic subclavian vein obstruction. Overcoming this obstruction could be very challenging. The current approaches of contralateral access, extraction and surgical intervention have significant drawbacks. This report presents an alternative approach that uses percutaneous subclavian balloon venoplasty successfully to regain venous access. We believe that this technique is safe and effective.