Left common carotid artery to left innominate vein arteriovenous fistula after transvenous laser lead extraction

Pacing Clin Electrophysiol. 2022 May;45(5):696-699. doi: 10.1111/pace.14439. Epub 2022 Jan 17.

Abstract

Transvenous lead extraction (TLE) is used for lead infection, lead debulking, venous recanalization and device upgrades. Lead extraction is performed using specialized tools including locking stylets, mechanical or rotating sheaths, femoral snares or laser sheaths. The most feared complications associated with lead extraction are bleeding, vascular tear, cardiac avulsion and tamponade. Despite technological progress, the incidence of major procedural complications including death remains slightly above 1%. This case depicts an asymptomatic left common carotid artery (LCCA) to left innominate vein arteriovenous fistula (AVF) after laser-assisted TLE successfully treated with an endovascular covered stent.

Keywords: device extraction; electrophysiology-clinical; imaging; instrumentation; surgery.

MeSH terms

  • Arteriovenous Fistula* / etiology
  • Arteriovenous Fistula* / surgery
  • Brachiocephalic Veins
  • Carotid Artery, Common
  • Defibrillators, Implantable* / adverse effects
  • Device Removal
  • Humans
  • Lasers
  • Pacemaker, Artificial*
  • Retrospective Studies
  • Treatment Outcome