Arteriovenous fistulae complicating cardiac pacemaker lead extraction: Recognition, evaluation, and management

Norman H. Kumins, James C. Tober, Charles J. Love, Tracey A. Culbertson, Mark A. Gerhardt, Randy J. Irwin, William L. Smead

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Transvenous pacemaker lead extraction has become a commonly performed procedure that is associated with a small but significant risk. We report two cases where lead extraction was complicated by arteriovenous fistulae between branches of the aortic arch and the left brachiocephalic vein. Presenting signs and symptoms included severe chest or back pain, persistent or copious bleeding from the venous puncture site, unexplained hypotension or anemia, superior vena cava syndrome, and signs of central venous hypertension or acute heart failure. One patient whose injury was not recognized immediately and who did not undergo repair died rapldly, whereas the other patient who was diagnosed quickly underwent successful repair. Immediate diagnosis with arteriography and rapid intervention with surgery or percutaneous techniques are indicated and may prevent mortality.

Original languageEnglish (US)
Pages (from-to)1225-1228
Number of pages4
JournalJournal of vascular surgery
Issue number6
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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