Symptomatic occlusion of the access vein after pacemaker or ICD lead extraction.

A lthough the North American Society of Pacing and Electrophysiology policy statement on lead extraction does not indicate non-functional leads as either class I or II indications (with the exception of non-functional leads in young patients), there is a tendency to view removal of any non-functional lead as desirable. 2 The protagonists for this vision argue that leads are neither permanent nor biocompatible, and non-functional leads should therefore pose a risk if not removed. One of the supposed risks is venous occlusion when an increasing number of leads are implanted. However, given the often disruptive nature of freeing the leads from the veins with extraction tools, lead extraction might predispose to thrombosis and venous obstruction. As there has been no follow up study of venous occlusion after lead extraction, we reviewed the incidence of symptomatic occlusions in patients who underwent lead extraction in our institution.