Pacemaker lead extraction and recapture of venous access: Technical problems arising from extensive venous obstruction

1 patient with a DDD pacemaker and chronic obstruction of the left subclavian and innominate veins coexisting with extensive stenoses in the upper caval vein, requiring extraction of 18-year-old leads.

Extraction of pacing leads, introduction of angiographic guidewires via Byrd dilatators, and introduction of new pacing leads using long sheaths originally dedicated for transvenous left ventricular leads implantation.