I have attached the follow up angiogram showing resolution of the clot previously seen on the subclavian pacemaker lead post thrombectomy and after two weeks of eliquis.  Whether the clot moved on its own with flow through the fistula, or if the clot dissolved or at least partially with eliquis is up for discussion.  I have spoken with the cardiologist regarding continuing long term anticoagulation in this patient and this will be determined at his follow up appointment.  I appreciate all the comments and lively discussion this case generated.  Happy Holidays to all and to all a good night!