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. 2017 Apr;33(2):150-151.
doi: 10.1016/j.joa.2016.06.007. Epub 2016 Aug 30.

Successful pacemaker lead extraction involving an ossified thrombus: A case report

Hideo Okamura  1 , John S Van Arnam  2 , Marie Christine Aubry  2 , Paul A Friedman  1 , Yong-Mei Cha  1
Affiliations

Successful pacemaker lead extraction involving an ossified thrombus: A case report

Hideo Okamura et al. J Arrhythm. 2017 Apr.

Abstract

A 41-year-old woman who had been fitted with a pacemaker 18 years prior presented for lead extraction because of device infection. First, we tried laser sheath. However, it cannot cross the binding in the innominate vein. Then we switched to the rotating mechanical sheath. Although it crunched through binding tissue, the progress halted. We removed the sheath and found pieces of calcified tissue in the sheath lumen. After removing the calcified tissue, both leads were extracted using the laser sheath, without complications. The pathological examination revealed a diagnosis of ossified thrombus. Venous thromboses associated with implanted leads can ossify with time, causing difficulties in the extraction of long-standing intravascular leads.

Keywords: Calcification; Lead extraction; Rotating mechanical sheath; Thrombus.

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Figures

Fig. 1
Fig. 1
A: Lead extraction using a rotating mechanical sheath. B: Bone-like tissue lodged in the sheath lumen.
Fig. 2
Fig. 2
Photomicrograph of the bone-like tissue stained by hematoxylin & eosin. A: ×40. B: ×200.
See this image and copyright information in PMC

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