Bailout Technique for a Detached Distal Tip of a Tissue-Stabilization Sheath During Transvenous Lead Extraction

CASE SUMMARY: A rare complication of distal tip detachment of the Evolution Steady Sheath has been reported previously. We describe a case in which a detached distal tip located in the innominate vein was successfully retrieved via the subclavian vein using a balloon-assisted technique during transvenous lead extraction. An 85-year-old man with pacemaker infection underwent lead extraction, during which the distal tip detached. A pull-through system was established, and balloon traction enabled successful retrieval through the pocket access. TAKE-HOME MESSAGE: The balloon-assisted pull-through technique is a useful retrieval strategy in cases of distal ring detachment of the Evolution Steady Sheath.