Retrieval of pacemaker lead tip embolized into the distal pulmonary arterial bed during extraction procedure.

A patient required lead extraction of a dual chamber implantable cardioverter defibrillator system for a chronic pocket infection. Using a right subclavian approach, the right ventricular leads were removed by dilation/counter traction. During the procedure, the tip of the atrial lead was cut and, while the body of the lead was extracted, the tip embolized into a distal branch of the right pulmonary artery. Despite its distal location, we were able to extract the lead tip by an Amplatz goose neck snare kit for intravascular foreign body retrieval, commonly used by interventional radiologists, in cooperation with our radiology staff.