Successful Minimally Invasive Management of Complex Vascular Access-Related Complications following Leadless Pacemaker Implantation

Abstract The management of acute limb ischemia, femoral artery pseudoaneurysm, and arteriovenous fistula formation following leadless pacemaker implantation presents a unique clinical challenge. This case report outlines a combined endovascular approach that integrates diagnostic imaging with therapeutic interventions to address these complications effectively. The proposed strategy includes endovascular stent deployment, intra-arterial thrombolytic therapy, and mechanical thrombectomy to restore perfusion in cases of acute limb ischemia. This multidisciplinary approach minimizes the need for open surgical repair. These findings underscore the efficacy of a coordinated endovascular strategy in managing complex vascular complications associated with the use of large-bore femoral sheaths.