Superior vena cava (SVC) obstruction occurs in patients with intrathoracic malignancies. Clinical symptoms can be distressing but presentation is insidious. We investigated the outcome of endovascular management for patients with SVC syndrome. We retrospectively reviewed the case histories of 17 patients (9 men) from January 2003 to June 2009. All patients had malignant disease. There were 24 interventions (2 patients with 2 interventions and 2 patients with 3 interventions). All had SVC stenosis over 90%. All patients were treated with intrathoracic angioplasty and stenting. All procedures were technically successful, and all patients had insertion of 10 to 18 mm diameter stents with symptom resolution in 16 patients. There were 2 occlusions at 1 and 6 weeks and 2 patients with restenosis (3 and 7 months). Endovascular intervention is technically feasible for SVC occlusion, relieves symptoms, and is a useful palliation measure.
Nicholson A. , Ettles D., Arnold A., Greenstone M., Dyet JFTreatment of malignant superior vena cava obstruction: metal stents for radiation . J Vasc Interv Radiol1997; 8(5): 781-788.
2.
Rice TW, Rodriguez RM, Light RWThe superior vena cava syndrome: clinical characteristics and evolving etiology . Medicine (Baltimore). 2006;85(1):37-42.
Thony F., Moro D., Witmeyer P., et al. Endovascular treatment of superior vena cava obstruction in patients with malignancies. Eur J Radiol. 1999;9(5):965-971.
6.
Kim YI, Kim KS, Ko YC, et al. Endovascular stenting as a first choice for the palliation of superiorvena cava syndrome. J Korean Med Sci. 2004;19(4):519-522.
7.
Aitken ML, Tonelli MRComplications of indwelling catheters in cystic fibrosis. Chest. 2000;118(6):1598-1602.
8.
Dinkel HP, Mettke B., Schmid F., Baumgartner I., Triller J., Do DDEndovascular Treatment of Malignant Superior Vena Cava Syndrome: Is Bilateral Wallstent Placement Superior to Unilateral Placement? J Endovasc Ther. 2003;10(4):788-797.
9.
Markman M.Diagnosis and management of superior vena cava syndrome. Cleve Clin J Med. 1999;66(1):59-61.
10.
Sculier JP, Evans WK, Feld R., et al. Superior vena caval obstruction syndrome in small cell lung cancer. Cancer. 1986; 57(4):847-851.
11.
Oudkerk M., Kuipers TJA, Schmitz PIM, Loosveld O., de Wit R.Self-expanding metal stents for palliative treatment of superior vena caval syndrome. Cardiovasc Intervent Radiol. 1996 ;19(3): 146-151.
12.
Kishi K., Sonomura T., Mitsuzane K., et al. Self-expandable metallic stent therapy for superior vena cava syndrome: clinical observations. Radiology. 1993;189(2):531-535.
Rowell NP, Gleeson FVSteroids, radiotherapy, chemotherapy and stents for superior vena cava obstruction for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin Oncol (R Coll Radiol). 2002 ;14(5):338-351.
15.
Schindlen, Vogelzang RL.Superior vena cava syndrome. Experience with endovascular stents and surgical therapy. Surg Clin North Am. 1999;79(3):983-994.
16.
Smayra T., Otal P., Chabbert V., et al. Long-term results of endovascular stent placement in the superior caval venous system. Cardiovasc Intervent Radiol. 2001;24(6):388-394.
17.
Masters GA, Vokes EEChemotherapy is for non-small cell lung cancer. Am J Respir Crit. 1995;151:1285-1287.
18.
Warde P., Payne D.Does thoracic irradiation improve survival and local control in limited-stage small cell carcinoma of the lung? A meta-analysis. J Clin Oncol. 1992;10(6):890-895.
19.
Rowell NP, Gleeson FVSteroids, Radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus (Cochrane review). Cochrane Database Syst Rev. 2001; 4:CD001316.
20.
Courtheoux P., Alkofer B., Refai M., Gervais R., Le Rochais JP, Icard P.Stent placement in superior vena cava syndrome . Ann Thorac Surg. 2003;75(1):158-161.
21.
Brown KT, Getrajdman GIBalloon dilation of the superior vena cava (SVC) resulting in SVC rupture and pericardial tamponade: a case report and brief review. Cardiovasc Intervent Radiol. 2005; 28(3):372-376.
22.
Monaco RG, Bertoni H., Pallota G., et al. Use of self-expanding vascular endoprostheses in superior vena cava syndrome. Eur J Cardiothor Surg. 2003 ;24(2):208-211.
23.
Dyet JF, Watts WG, Ettles DF, Nicholson AAMechanical properties of metallic stents: how do these properties influence the choice of stent for specific lesions? Cardiovasc Intervent Radiol. 2000;23(1):47-54.
24.
Lanciego C. , Chacon JL, Julian A., et al. Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. AJR AmJ. Roentgenol. 2001;177(3):585-593.
25.
Urruticoechea A., Mesia R., Dominguez J., et al. Treatment of malignant superior vena cava syndrome by endovascular stent insertion. Experience on 52 patients with lung cancer. Lung Cancer. 2004;43(2):209-214.
26.
Oderich GSC , Treiman GS, Schneider P., Bhirangi K.Stent placement for treatment of central and peripheral venous obstruction: a long-term multi-institutional experience . J Vasc Surg. 2000; 32(4):760-769.
