Abstract
Recalled St Jude Medical Riata leads have a high rate of insulation failures with potential thrombogenic externalized conductors. We report a paradoxical thromboembolic stroke through a persistent foramen ovale during extraction of a lead with externalization. We suggest mandatory transesophageal echocardiography prior to extraction to screen for lead-related thrombosis and routes of right-to-left shunting to reduce risk of thromboembolic complications.
MeSH terms
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Adult
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Defibrillators, Implantable*
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Device Removal / adverse effects*
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Echocardiography, Transesophageal
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Electric Countershock / instrumentation*
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Embolism, Paradoxical / diagnosis
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Embolism, Paradoxical / etiology*
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Foramen Ovale, Patent / complications*
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Foramen Ovale, Patent / diagnosis
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Humans
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Male
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Medical Device Recalls*
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Patient Selection
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Predictive Value of Tests
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Prosthesis Design
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Risk Factors
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Stroke / diagnosis
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Stroke / etiology*
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Treatment Outcome