THROMBOSIS OR VENOUS STENOSIS
Class I
1. Lead removal is recommended in patients with clinically significant thromboembolic events associated with thrombus on a lead
or a lead fragment. (Level of evidence: C)
2. Lead removal is recommended in patients with bilateral subclavian vein or SVC occlusion precluding implantation of a needed
transvenous lead. (Level of evidence: C)
3. Lead removal is recommended in patients with planned stent deployment in a vein already containing a transvenous lead, to
avoid entrapment of the lead. (Level of evidence: C)
4. Lead removal is recommended in patients with superior vena cava stenosis or occlusion with limiting symptoms. (Level of
evidence: C)
5. Lead removal is recommended in patients with ipsilateral venous occlusion preventing access to the venous circulation for
required placement of an additional lead when there is a contraindication for using the contralateral side (e.g. contralateral AV
fistula, shunt or vascular access port, mastectomy). (Level of evidence: C)
Class IIa
1. Lead removal is reasonable in patients with ipsilateral venous occlusion preventing access to the venous circulation for required
placement of an additional lead, when there is no contraindication for using the contralateral side. (Level of evidence C)