Case repor t
A 54-year-old woman with history of complete heart block status post
biventricular permanent pacemaker (BiV-PPM) implantation, three years
prior, presented with persistent left arm pain and swelling that
resulted in limitations of her daily activities. Physical examination
revealed edema above the clavicle, the arm and the hand. The remainder
of the physical examination was unremarkable. Subclavian venogram
revealed total occlusion of her left subclavian vein. Recognizing the
limitations of balloon dilation alone and the risk and uncertain results
of lead extraction followed by stenting an alternative strategy was
sought. Given the favorable results of adding a drug coated balloon to
high pressure balloon dilation in patients with stenotic dialysis
fistulas we decided to add the drug coted balloon to high pressure
balloon dilation.