Key result
Pacemaker lead extraction results in paradoxical leg artery embolism of a broken fragment via PFO.
Case Report (n=1)
Highlights the risk of paradoxical embolism during pacemaker lead extraction in patients with a patent foramen ovale, suggesting a potential role for pre-procedural echocardiography.
May warrant PFO screening before lead extraction; leaves open whether imaging reduces embolic events.
Extraction of three chronically implanted pacemaker leads was performed via the implant vein in a 71-year-old man. One of the leads broke in the subclavian scar tissue. The lead fragment migrated into the left peroneotibial trunk artery. Transesophageal echocardiography showed patent foramen ovale associated with right-to-left atrial shunt. This complication of lead extraction is discussed along with the role of echocardiography prior to lead removal.
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Dieuzaide et al. (1998) conducted a case report in Pacemaker lead extraction complication (n=1). Pacemaker lead extraction was evaluated. Extraction of chronically implanted pacemaker leads in a 71-year-old man resulted in paradoxical embolism of a broken lead fragment into a leg artery via a patent foramen ovale.
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