Paradoxical thromboembolic stroke during extraction of a recalled St Jude Medical Riata defibrillator lead with conductor externalization.
Recalled St Jude Medical Riata leads have a high rate of insulation failures with potential thrombogenic externalized conductors. We report a paradoxical thromboembolic stroke through a persistent foramen ovale during extraction of a lead with externalization. We suggest mandatory transesophageal echocardiography prior to extraction to screen for lead-related thrombosis and routes of right-to-left shunting to reduce risk of thromboembolic complications.
Department of Cardiology and Center for Cardiovascular Research, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
Jacob M
JM
Larsen
Dominic A M J
DA
Theuns
Anna M
AM
Thøgersen
D000328:Adult; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock / Q000295:instrumentation*; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology*; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D057052:Medical Device Recalls; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome