Internal Mammary Arterial Injury from Lead Extraction: A Clinically Subtle yet Important Complication of Implantable Device Removal

• Type of Material: Article
• Authors: Cesar Cruz, Emory University; Jonathan J Langberg, Emory University; Stamatios Lerakis, Emory University; Ravi K Veeraswamy, Emory University; Michael S Lloyd, Emory University
• Language: English
• Date: 2011-03-05
• Publisher: Hindawi Publishing Corporation
• Publication Version: Final Published Version
• Copyright Statement: © 2011 Cesar Cruz et al.
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://www.hindawi.com/journals/crp/2011/408640/
• Title of Journal or Parent Work: Cardiology Research and Practice
• ISSN: 2090-8016
• Volume: 2011
• Issue: 2011
• Start Page: 1
• End Page: 5
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Percutaneous implantable device extraction has increased in recent years and is associated with small but significant risk. Arteriovenous fistula formation is an uncommon complication of this procedure. We report two cases where lead extraction was complicated by an arteriovenous fistula between the left internal mammary artery and the left brachiocephalic vein. In both cases, the patients were asymptomatic and the presence of a continuous murmur in the left subclavicular region led to the appropriate diagnosis. These were successfully treated with coil embolization. Auscultation around prior extraction sites should be routinely done to aid in the diagnosis of this potentially harmful complication.