Figure 3. A case with CS perforation due to repeated CS
cannulations with an Outer-Cath
A: Although an LV lead was successfully placed with an Outer-Cath, it
was repeatedly dislodged when peeling off the Outer-Cath. B: Leakage of
contrast medium was observed in the pericardial space due to CS
perforation caused by the repeated cannulations of the Outer-Cath into
the CS. C,D: An LV lead placement was successfully guided by use of an
Inner-Cath alone. (white arrows indicate where the Inner-Cath ends)
Figure 4. LV-LP guided by Inner-Cath alone after venoplasty in a
case with occluded left brachiocephalic vein .
A: This patient’s left brachiocephalic vein (LBCV) was completely
occluded. B: An 0.014-inch guidewire was passed thorough the occluded
LBCV with a retrograde approach using a microcatheter. C: Another
0.014-inch wire was passed through the LBCV with an anterograde approach
after dilation of the occluded LBCV. D: A 7Fr sheath was inserted
through the occluded LBCV. E: An Inner-Cath was advanced into the CS
using a 5Fr EP catheter. F: LV lead placement was successfully guided by
an Inner-Cath alone.