Paclitaxel Coated Balloon Fibroplasty: A more effective treatment of
chronic symptomatic lead-related venous obstruction?
Subclavian venous obstruction is a common complication after cardiac
device placement. Patients typically remain asymptomatic but at times
may present with acute symptoms due to thrombus formation immediately
after device placement or years later, due to chronic obstruction, with
pain and swelling. Various techniques have been attempted to resolve
symptoms in patients with chronic lead-related subclavian obstruction
but are associated with a high recurrence of restenosis. Drug coated
balloons (DCB) have been used subsequently after pre-dilation with
high-pressure balloons, of the stenosed region, in patients with
arteriovenous fistula obstruction, and have shown promising results. We
discuss the utilization of DCB in our patient with chronic subclavian
obstruction due to a permanent pacemaker lead.