Endovascular treatment of stenoses in the superior vena cava syndrome caused by non-tumoral lesions

Abstract

We report our experience in percutaneous treatment of non-tumoral superior vena cava syndrome (SVCS) between December 1998 and July 2001. During a period of 2.5 years, 9 patients (age range 27-84 years, mean age 50 years) were treated percutaneously for significant non-tumoral SVCS. Symptomatic SVCS were due to dialysis catheters (7), central line (1) and radiation therapy (1). In thrombotic occlusions and severe stenosis, a preliminary in situ thrombolysis was achieved before angioplasty. Patients were followed by echo-Doppler, computed tomography angiography (CTA), magnetic resonance angiography (MRA), or phlebography. Complete recanalization of the veins and immediate resolution of symptomatic SVCS were obtained in all patients, with no procedure-related complication. Thirteen stents were placed in 9 patients with a mean clinical follow-up of 9.1 months (range 2-23 months). One hundred percent patency at 6 months was obtained. Two patients recurred twice and were treated with new stent placement. At 12 months the patency was 67% and assisted patency was 100%. Stent placement in benign symptomatic SVCS is a safe and minimally invasive procedure, with no technical and clinical complications in our experience. It allowed immediate relief of symptoms, and in dialysed patients could provide continued use of hemodialysis access. Close clinical surveillance is mandatory to assess stent patency.

Outcome and Management of Pacemaker‐Induced Superior Vena Cava Syndrome

“…This treatment strategy is challenged by its low long‐term efficacy. Fortunately, stent patency can be restored by repeat intervention for most patients . Surgical treatment with venous reconstruction and implantation of an epicardial lead may be an alternative option for patients with SVC obstruction that is refractory to endovascular interventions …”

A Case of Pacemaker Related Superior Venacaval Syndrome after Thoracic Surgery

“…Malignant processes of the mediastinum cause majority of cases of SVCO and only 5-10% of them are related to nonmalignant causes. 1 The exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the past two decades has resulted in more patients with SVCO of benign etiology. 2 Pacemaker and defibrillator leads can cause central venous obstruction or occlusion, as demonstrated by various studies by using contrast venography, done during wire changes which range from 64% to 23%.…”

A Case of a Bloated Face: SVC Syndrome Relieved by an Endovascular Approach

“…The use of endovascular procedures is becoming more prevalent with the main goal being the relief of symptoms of obstruction and improving the overall quality of life of the patient. 4,5,10 Therapy for nonmalignant SVC obstruction should typically be aimed at the underlying etiology, but medical therapy with the use of anticoagulation may provide relief in certain individuals. When this is unsuccessful in alleviating the symptoms, more invasive procedures may provide an attractive alternative management option.…”