Pulmonary arterial embolization of pacemaker lead electrode tip.
Complications with extraction of abundant endovascular systems increase with time since implantation. As the number of implanted devices increases, successful management of complications needs to be disseminated. We present a 46-year-old woman with endovascular leads placed 15 years previously requiring extraction. Using laser-assistance the leads were removed, although the passive lead tips were unable to be extracted, and were retained in the superior vena cava. One lead tip embolized to the distal pulmonary bed within 24 hours of her operative procedure. Computed tomography and pulmonary arteriography suggested a near immediate thrombogenic process. A multidisciplinary approach was utilized to identify management strategies that allowed for a satisfactory patient outcome.
Eckart
Robert E
RE
Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. robert.eckart@us.army.mil
Hruczkowski
Tomasz W
TW
Landzberg
Michael J
MJ
Ames
Alyson
A
Epstein
Laurence M
LM
D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D020878:Device Removal; D004562:Electrocardiography; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior
D000925:Anticoagulants