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. 2000 Jun;83(6):e12. doi: 10.1136/heart.83.6.e12

Exchange of pacing or defibrillator leads following laser sheath extraction of non-functional leads in patients with ipsilateral obstructed venous access

F Bracke, L M van Gelder, N Sreeram, A Meijer
PMCID: PMC1760879  PMID: 10814646

Abstract

Occlusion of the subclavian or brachiocephalic vein in pacemaker or defibrillator patients prohibits ipsilateral implantation of new leads with standard techniques in the event of lead malfunction. Three patients are presented in whom laser sheath extraction of a non-functional lead was performed in order to recanalise the occluded vein and to secure a route for implantation of new leads. This technique avoids abandoning a useful subpectoral site for pacing or defibrillator therapy. The laser sheath does not affect normally functioning leads at the same site.


Keywords: laser sheath; venous occlusion; pacemaker; lead extraction

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Figure 1  .

Figure 1  

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Preoperative phlebography of patient 3. The defibrillator lead is inserted via the left subclavian vein (arrow). There is occlusion from the site of insertion to the superior caval vein. Collaterals drain via the right brachiocephalic vein into the superior caval vein. An abandoned artial lead from the right side is also present.

Selected References

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