This report describes a 69-year-old Japanese woman with bilateral fore
arm thrombophlebitis that developed soon after transvenous permanent p
acemaker insertion. Intravenous administration of urokinase and hepari
n rapidly resolved fever, painful forearm swelling and inflammatory fi
ndings. Digital subtraction venograms revealed a brachiocephalic vein
thrombosis. A ten-month treatment with warfarin and ticlopidine result
ed in the complete restoration of venous flow. Although thrombophlebit
is associated with transvenous permanent pacemaker insertion has a rel
atively low incidence (0.3%), prompt diagnosis and treatment with anti
coagulant and/or thrombolytic agents are important for the late clinic
al outcome in cases with deep venous thrombosis.