Percutaneous closure and 'push-pull' technique to repair arterial lead and sheath placement complicating cardiac resynchronization therapy

We present a case of inadvertent subclavian arterial puncture and lead placement to the left ventricle in a patient undergoing cardiac resynchronization therapy. We describe the use of a "push-pull" technique within an arterial setting to allow removal of the lead, while maintaining access through the same puncture to allow an arterial-closure device to then seal the artery at this site. As a result of this percutaneous approach, the patient avoided the need for a vascular surgical procedure.