Publication Date

2-1-2020

Journal

The Texas Heart Institute Journal

DOI

10.14503/THIJ-18-6713

PMID

32148448

Publication Date(s)

February 2020

Language

English

PMCID

PMC7046357

PubMedCentral® Posted Date

2-1-2020

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Aged, Angioplasty, Balloon, Cardiac Resynchronization Therapy, Cardiac Resynchronization Therapy Devices, Catheterization, Peripheral, Constriction, Pathologic, Device Removal, Equipment Design, Female, Heart Failure, Humans, Male, Middle Aged, Peripheral Vascular Diseases, Punctures, Treatment Outcome, Veins

Abstract

The number of procedures for upgrading implantable devices for cardiac resynchronization therapy has increased considerably during the last decade. A major challenge that operators face in these circumstances is occlusion of the access vein. We have modified a pull-through method to overcome this obstacle. Six consecutive patients with occluded access veins and well-developed collateral networks underwent a procedure in which the occluded vein was recanalized by snaring the existing atrial lead via transfemoral access. Upgrading the device was successful in all patients; none had intraprocedural complications. Our experience shows that our modified pull-through technique may be a feasible alternative for upgrading cardiac resynchronization therapy in patients with venous occlusion.

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