Implantation of implantable cardioverter-defibrillators from an ileofemoral approach

Patients needing an implantable cardioverter defibrillator (ICD) system, but without suitable access from jugular or subclavian routes present a vexing problem. Such patients would normally undergo thoracotomy for epicardial lead placement. However, for patients who decline such an intervention, there have been no alternatives for them. There is scarce data from the published literature addressing this dilemma. We report two cases of successful ICD and biventricular ICD placement from an ileofemoral approach.