Why the study?
Subclavian vein obstruction in patients with pacemaker leads can make the implantation of new pacemaker leads difficult.
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Balloon venoplasty and contralateral puncture with tunneling are viable techniques for overcoming total central vein occlusion during cardiac device upgrades.
BACKGROUND: Subclavian vein obstruction may occur in patients with pacemaker leads, which may make the implantation of new pacemaker leads difficult. CASE SUMMARY: We report two cases in which upgrading to cardiac resynchronization therapy pacemaker was challenging due to total central vein occlusion. In the first case, a 78-year-old woman with permanent pacemaker implantation, 5 years ago, was successfully treated by balloon venoplasty. In the second case, balloon venoplasty was unsuccessful in a 46-year-old woman who has received twice single-chamber implantable cardioverter-defibrillator, 12 years and 5 years ago, due to vessel crowding, so a contralateral side puncture, along with a tunnel technique, was performed to solve this problem. DISCUSSION: Cardiac implantable electronic device-related subclavian vein stenosis can present a challenge to common cardiac resynchronization therapy device upgrades in the absence of appropriate techniques.
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Lu et al. (2020) studied this question.
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