Key result
Coumadin discontinuation linked to recurrent PE in a patient with DVI pacemaker lead thrombus.
Case Report (n=1)
This case suggests that lifelong anticoagulation may be indicated in patients who develop pulmonary embolization or venous thrombosis around pacemaker leads.
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Recurrent embolization after Coumadin cessation may indicate lifelong anticoagulation for lead thrombosis; hypothesis-generating case report requiring confirmation.
A 44-year-old man developed recurrent pulmonary embolization after implantation of a permanent transvenous DVI pacemaker connected to polyurethane leads. Thrombus was found in the left innominate and subclavian veins around the pacemaker leads, but not in the right atrium or in the venous system of the pelvis and the lower extremities. The recurrence of pulmonary embolization followed discontinuation of treatment with Coumadin. This case demonstrates that lifelong anticoagulation is indicated in patients who have had pulmonary embolization and/or venous thrombosis around the pacemaker leads.
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Pasquariello et al. (1984) conducted a case report in Recurrent pulmonary embolization (n=1). Discontinuation of Coumadin was evaluated on Recurrent pulmonary embolization. Discontinuation of Coumadin led to recurrent pulmonary embolization in a patient with thrombus around permanent transvenous DVI pacemaker leads.
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