Successful Interventional Management for Pulmonary Arterial Injury Secondary to Pacemaker Implantation
Subclavian vein puncture is a relatively fast and safe technique to access the right heart for placement of pacemaker leads. Hemothorax related to injury of the pulmonary artery (PA) is a rare complication of subclavian vein access but can be life-threatening. We report a case of hemothorax occurring after subclavian vein puncture for pacemaker implantation. No cases of transcatheter arterial embolization for PA injury secondary to pacemaker implantation have been reported. Understanding of this rare complication after pacemaker implantation along with its specific clinical presentation may lead to early diagnosis and intervention.
Budd-Chiari syndrome (BCS) with an intracaval stent is a rare presentation. In most Western patients with BCS, it is predominantly the hepatic veins that are involved, not the inferior vena cava (IVC). In the case presented, the patient had antiphospholipid syndrome with BCS that involved the IVC and required an intracaval stent. Presented with the case study are scanning techniques for BCS and the IVC to help sonographers evaluate the normal and abnormal anatomy and hemodynamics of this system.