Fistula from right internal mammary artery to superior vena cava after use of a laser sheath to extract a pacemaker lead

Tex Heart Inst J. 2012;39(5):727-30.

Abstract

A 55-year-old woman presented with dyspnea on exertion due to a right internal mammary artery-to-superior vena cava arteriovenous fistula that occurred after pacemaker lead extraction with a laser sheath. The fistula was successfully repaired by placing a covered stent in the right internal mammary artery. In this unusual location, endovascular stenting is a reasonable alternative to coil embolization or surgical repair of an arteriovenous fistula resulting from laser lead extraction.

Keywords: Arteriovenous fistula/etiology/therapy; blood vessel prosthesis/implantation; defibrillators, implantable; device removal/adverse effects/methods; electrodes, implanted; iatrogenic disease; laser therapy; lasers, excimer/adverse effects; mammary artery, right internal; pacemaker, artificial; stent-graft; vena cava, superior.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / etiology*
  • Arteriovenous Fistula / therapy
  • Catheters / adverse effects*
  • Device Removal / adverse effects*
  • Device Removal / instrumentation
  • Dyspnea / etiology
  • Endovascular Procedures / instrumentation
  • Equipment Design
  • Female
  • Humans
  • Lasers, Excimer / adverse effects*
  • Mammary Arteries* / diagnostic imaging
  • Middle Aged
  • Pacemaker, Artificial*
  • Radiography
  • Stents
  • Treatment Outcome
  • Vena Cava, Superior* / diagnostic imaging