Imagerie Diagnostique Et Thérapeutique De La Veine Cave Supérieure

Kissing Stents for Superior Vena Cava Syndrome Due to Mediastinal Fibrosis

“…7 Surgery for SVCS depends on urgency, cause, and location of the obstruction. [1][2][3][4][5][6][7][8] Open surgical repair is an option if endovascular repair is not appropriate or fails. [3][4][5]7,8 Emergency treatment is required in cases of airway obstruction, cerebral oedema, or pericardial effusion.…”

“…3,7 Regular follow-up and reintervention are required to maintain patency and long-term clinical success. 3,7 SVC stenting was first described in 1986 2,6,7 and is now a well-established treatment in benign cases of SVCS [2][3][4][5]8,11 related to MF. 8,10 The advantages of stenting include the rapid relief of symptoms, low morbidity, long-term patency, and a minimally invasive approach that can be performed under local anaesthesia or conscious sedation.…”

“…She presented with symptoms including cough, weakness, weight loss (15 kg), thoracic pain, distended collateral venous circulation of the thorax, and significant oedema for 2 years (moderate SVCS and Kishi score = 5). [1][2][3][4][5][6][7][8] She had no history of central venous device placement or thrombophilic risk. Lymphoma or recurrence of tuberculosis was suspected.…”

“…Intraoperative venograms performed via the right and left arms confirmed pre-occlusive stenosis of the right internal jugular (IJ) and innominate veins and SVC with extensive collateral veins and type 4 SVCS according to the Standford Classification ( Figure 2). [1][2][3][4][5][6][7][8] We decided not to perform mediastinoscopy because of prior negative biopsies on endobronchial ultrasounds.…”

“…1 According to Stanford et al, 4 types of SVCS have been described depending on the collateral venous return and serve to identify patients at risk of cerebral or airway compromise. [1][2][3][4][5][6][7][8] Historically, open debulking of fibrosis and venous reconstruction was the only therapeutic option. However, this palliative procedure carried significant risk and frequent recurrence.…”