Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Nov 3;4(24):101633.
doi: 10.1016/j.jaccas.2022.08.044. eCollection 2022 Dec 21.

A Unique Case of Central Line Fracture Due to Laser Lead Extraction

Arooge Towheed  1 , Alexander Smith  2 , Malik Ghawanmeh  3 , Apostolos Tsimploulis  1 , Cyrus Hadadi  1 , Athanasios Thomaides  1
Affiliations
Case Reports

A Unique Case of Central Line Fracture Due to Laser Lead Extraction

Arooge Towheed et al. JACC Case Rep. .

Abstract

Transvenous laser-assisted lead extraction is successful, with a low procedural complication rate for a wide range of indications. Here, we report a case of right internal jugular triple-lumen central venous catheter fracture and subsequent embolism to the right pulmonary artery during laser lead extraction that was successfully retrieved with a gooseneck snare. (Level of Difficulty: Advanced.).

Keywords: CVC, central venous catheter; ICD, implantable cardioverter-defibrillator; RV, right ventricle; central venous catheter; implantable cardioverter-defibrillator; laser lead extraction.

PubMed Disclaimer

Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Baseline Preoperative Chest X-Ray Baseline preoperative chest x-ray with single-chamber implantable cardioverter-defibrillator (blue arrow) and right internal jugular central venous catheter (yellow arrow).
Figure 2
Figure 2
Central Venous Catheter Fragment in Right Pulmonary Artery Central venous catheter fragment in right pulmonary artery (blue arrow).
Figure 3
Figure 3
Remaining Proximal Portion of Central Venous Catheter After Removal Charring and burn marks are evident at the distal tip of the catheter (blue arrow).
Figure 4
Figure 4
Distal Tip of Fractured Central Venous Catheter Distal tip of fractured central venous catheter with burn marks (blue arrow).
Figure 5
Figure 5
Angiography of Right Pulmonary Artery (A, B) Angiography of right pulmonary artery localizing the position of catheter fragment.
Figure 6
Figure 6
Fluoroscopy View of Embolized Catheter Tip Fluoroscopy view of embolized catheter tip with snare (blue arrow).
Figure 7
Figure 7
Fragmented End of Retrieved Catheter Fragmented end of the catheter retrieved with snare tool (white arrow).
See this image and copyright information in PMC

References

    1. Kusumoto F.M., Schoenfeld M.H., Wilkoff B.L., et al. 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm. 2017;14:e503–e551. - PubMed
    1. Farooqi F.M., Talsania S., Hamid S., Rinaldi C.A. Extraction of cardiac rhythm devices: indications, techniques and outcomes for the removal of pacemaker and defibrillator leads. Int J Clin Pract. 2010;64:1140–1147. - PubMed
    1. Bahadır N., Canpolat U., Kaya E.B., et al. Comparison of acute and long-term outcomes of Evolution(®) and TightRail™ mechanical dilator sheaths during transvenous lead extraction. J Cardiovasc Electrophysiol. 2021;32:1395–1404. - PubMed
    1. Wilkoff B.L., Byrd C.L., Love C.J., et al. Pacemaker lead extraction with the laser sheath: Results of the pacing lead extraction with the excimer sheath (PLEXES) trial. J Am Coll Cardiol. 1999;33:1671–1676. - PubMed
    1. Sood N., Martin D.T., Lampert R., Curtis J.P., Parzynski C., Clancy J. Incidence and predictors of perioperative complications with transvenous lead extractions: Real-world experience with National Cardiovascular Data Registry. Circ Arrhythm Electrophysiol. 2018;11 - PubMed

Publication types

LinkOut - more resources