Jay Mohan: Thrombectomy and Balloon Angioplasty for Pacemaker-Induced Thrombosis
Jay Mohan, Interventional Cardiologist at McLaren Macomb Medical Center, shared a post on LinkedIn:
“And another one! Pacemaker induces thrombosis
Here is great case of a pacemaker induced left subclavian and axillary vein DVT. Patient presented with significant left arm pain about eight months after pacemaker implantation for complete heart block.
Doppler demonstrated occluded subclavian through brachial veins. Interventional Cardiology was consulted for assessment and consideration for thrombectomy.
So we brought the patient to the Cath Lab and gained access to the left brachial vein. Imaging demonstrated complete occlusion of the left subclavian vein. Likely due to fibrosis from the pacemaker leads at the junction of the clavicle.
To treat this, we elected to use the Penumbra BOLT 12 thrombectomy device. This device is unique and that it has a powerful computer-assisted vacuum device that uses saline in a column to create a maceration effect. With one pass, we were able to remove the thrombus that you can see in the pictures. Following this based on IVUS guidance, we perform performed venoplasty of the fibrotic segment followed by AV fistula drug coated balloon. Final imaging demonstrated excellent result. Patient will be maintained on anticoagulation.
Another great case demonstrating the safety of using thrombectomy even in the presence of pacemaker leads, as well as the novel use of drug coated balloon to treat venous fibrosis.”
Proceed to the video attached to the post.
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