Complete Occlusion of Subclavian Venous Access: An Unexpected Troubleshoot During Permanent Pacemaker Pulse-Generator Replacement

Pande, Arindam; Sarkar, Achyut; Ahmed, Imran; Chandra, Naveen

doi:10.4103/2321-449x.158883

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2017

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“…On the one hand, leads present an increased risk potential for the development of thrombosis and acute vessel occlusions [24][25][26][27][28][29][30][31][32][33][34][35][36]. On the other hand, complications are frequently encountered during the explantation of defective leads due to fibrous adhesion sites with the vessel wall or an almost complete encapsulation into a neointimal tissue pocket created by the lead (Fig.…”

Section: Lead Issuesmentioning

confidence: 99%

Neointimal fibrotic lead encapsulation – Clinical challenges and demands for implantable cardiac electronic devices

Keiler

Schulze

Sombetzki

et al. 2017

Journal of Cardiology

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Every tenth patient with a cardiac pacemaker or implantable cardioverter-defibrillator implanted is expected to have at least one lead problem in his lifetime. However, transvenous leads are often difficult to remove due to thrombotic obstruction or extensive neointimal fibrotic ingrowth. Despite its clinical significance, knowledge on lead-induced vascular fibrosis and neointimal lead encapsulation is sparse. Although leadless pacemakers are already available, their clinical operating range is limited. Therefore, lead/tissue interactions must be further improved in order to improve lead removals in particular. The published data on the coherences and issues related to lead associated vascular fibrosis and neointimal lead encapsulation are reviewed and discussed in this paper.

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