Opening an occluded subclavian vein with a screw-like flexible hollow guide-wire and venoplasty.
Patients with existing internal cardioverter defibrillators (ICDs) often require upgrading to a biventricular ICD for treatment of congestive heart failure (CHF). Placement of a left ventricular (LV) lead can be technically challenging in the best of circumstances. A subclavian vein stenosis or occlusion related to previously placed leads adds a major obstacle to a successful implant. We report a technique of implanting an LV lead from the same side as the existing ICD system despite complete occlusion of the subclavian vein.
Worley
Seth Joseph
SJ
Lancaster Heart and Stroke Foundation, Lancaster General Hospital, Lancaster, Pennsylvania, USA. seth@mcworley.com
Gohn
Douglas Charles
DC
Pulliam
Robert Ward
RW
D000368:Aged; D003251:Constriction, Pathologic; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D013350:Subclavian Vein / Q000473:pathology / Q000601:surgery*