Percutaneous management of superior vena cava occlusions

Crowe, Martin; Davies, Christine Helen; Gaines, Peter A.

doi:10.1007/bf00338303

Cited by 64 publications

(35 citation statements)

References 6 publications

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“…(36) In another study, involving eleven patients monitored for one to eleven months, only one case of recurrence was observed. (37) The authors of yet another study achieved clinical success in 93% of the patients treated, with no recurrences during a one-to fourteen-month follow-up period. (23) In still another study, no long-term follow-up evaluation was made because the patients all died prematurely from the underlying disease.…”

Section: Clinical Resultsmentioning

confidence: 92%

“…In three different studies involving a total of 56 patients, one case of recurrence of SVCS secondary to the growth of the tumor was reported. (28)(29)37) The authors of all three studies employed Gianturco stents, suggesting that the open architecture of the stent leaves it more susceptible to proliferation of the tumor. Such tumor infiltration has not been reported with use of the Wallstent or Palmaz stents, although tumor growth can occur along the borders of all types of stents, resulting in recurrence of the symptoms.…”

Section: Clinical Resultsmentioning

confidence: 99%

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Tratamento da síndrome da veia cava superior

et al. 2005

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The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis) and symptoms (headache, dyspnea, cough, orthopnea and dysphagia) caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return secondary to intra-atrial or intraluminal diseases. From 73% to 93% of all cases of superior vena cava syndrome occur during the development of an intrathoracic tumor. Most patients presenting superior vena cava syndrome secondary to malignant neoplasms are treated without surgery, through radiotherapy, chemotherapy or the use of intraluminal stents. When the etiology of superior vena cava syndrome is benign, it can be treated with clinical measures (anticoagulation, raising the head, etc.) or, in refractory cases, with angioplasty, stents or surgery.

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Section: Clinical Resultsmentioning

confidence: 92%

Section: Clinical Resultsmentioning

confidence: 99%

Tratamento da síndrome da veia cava superior

et al. 2005

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“…O sucesso técnico inicial do tratamento endovascular varia de 90 a 100% na literatura. A taxa de perviedade geral fica em torno de 77 a 85%, e assistida entre 85 e 91%, com seguimento de 17 meses 11,18,26 . As taxas de reestenose observadas variam de 0 a 45% 22,23 .…”

Section: Discussionunclassified

“…As complicações relacionadas à colocação de stent são pouco freqüentes, variando de 7 a 19% 17,18,26 . A migração do stent é uma complicação rara, mas grave, podendo levar ao óbito 1,10,11 .…”

Section: Discussionunclassified

Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura

et al. 2006

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We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the right brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloonexpandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.Keywords: Angioplasty, vena cava, stenosis. ResumoRelatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior.Palavras-chave: Angioplastia, veia cava, estenose.

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“…Recurrence of SVCS due to tumour progression has been reported by several authors, it may cause compression of the stented SVC [55] or may lead to ingrowth of tumorous tissue into the lumen of the vessel [7].…”

Section: Figurementioning

confidence: 99%

Superior Vena Cava Syndrome. From the Bronchus to the Vessel

Witt

Schmidt

Borges

et al. 1997

Diagnostic and Therapeutic Endoscopy

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This paper addresses the diagnosis and management of superior vena cava syndrome (SVCS) due to malignant intrathoracic tumours. Diagnosis of SVCS is usually established by bedside examination. Chest X-ray and computed tomography may be helpful, but the cavography remains the "gold-standard .O ther imaging techniques (MRI, nuclear flow studies) are more of scientific interest. Bronchoscopy helps to evaluate the risk of pulmonary complications and endoscopic procedures often lead to histological findings. In the treatment of malignant SVCS surgery, radiotherapy, and chemotherapy have been successfully used. The placement of a vascular stent might be an additional or alternative possibility. There are no conclusive indication criteria and no conclusive regimen concerning post-stenting anticoagulation. From all reported results and published papers we draw the conclusion that the immediate effects of stent implantation and the long-term results of tumour-specific therapy are complementary to one another. The stent dilates the local venous stenosis while tumour-specific therapy has a general effect on the vascular and respiratory situation in a multi-therapy concept.

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Percutaneous management of superior vena cava occlusions

Abstract: The percutaneous management of complete SVC occlusion with thrombolysis and/or clot aspiration followed by stent insertion is safe and effective, giving sustained symptomatic relief.

Cited by 64 publications

References 6 publications

Tratamento da síndrome da veia cava superior

Tratamento da síndrome da veia cava superior

Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura

Superior Vena Cava Syndrome. From the Bronchus to the Vessel

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