In a 29-year-old man with a malfunctioning implantable cardioverter- defibrillator (ICD) lead, a collateral vein connected to the superior vena cava had well developed with the left subclavian vein occlusion. A new ICD lead was successfully implanted through this angulated and tortuous collateral vein using a long sheath. This may be another strategy for implanting additional leads in central venous occlusions. © 2010 The Author.
