A case of symmetrical peripheral gangrene associated with transvenous lead extraction

Introduction Central venous vascular tears constitute the most lethal complication encountered during transvenous lead extraction. Although they are infrequent, the case fatality rate for these events has been reported as high as 63% owing to rapid exsanguination. Of those who survive these encounters, significant morbidity often follows. In this report, we describe a case of symmetrical peripheral gangrene (SPG) following endovascular laceration during laser lead extraction. SPG is a rare but well-documented clinical syndrome characterized by ischemic necrosis simultaneously involving the distal portions of 2 or more extremities without any proximal arterial obstruction or vasculitis.