A method for creating a pathway for insertion of a medical lead, such as a defibrillation lead, the method includes creating an incision at a first location on the left side of the torso of the patient. A first medical device and a second medical device are advanced through the incision and through the subcutaneous tissue toward a second location proximate the center of the torso. The distal end of the first medical device is deflected at the second location toward a third location proximate the high sternal area. The second medical device is advanced out through the distal end of the first medical device toward the third location. A sheath is positioned within the torso, the sheath spanning the distance between the first location and the second location and the distance between the second location and the third location.