Femoral artery extraction with adjunctive balloon occlusion is a feasible technique for removing inadvertently placed left ventricular pacing leads while minimizing embolic and bleeding risks.
May support femoral extraction for misplaced LV leads in select cases; leaves open need for prospective safety data before broader use.
We describe the extraction of a pacing lead via the femoral artery 5 months after it was inadvertently introduced through the right subclavian artery and positioned in the left ventricle. The lead was dislocated from the myocardium by traction from the subpectoral area and subsequently removed with a retriever inserted through the femoral artery in order to minimize the risk of cerebral embolization and bleeding at the entry site. Bleeding was controlled at the subclavian artery entry site by temporary inflation of a balloon catheter inserted through the brachial artery, and at the insertion site of the retriever in the femoral artery with a closure device.
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Bracke et al. (2003) studied this question.
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