Percutaneous treatment of superior vena cava syndrome using metallic stents

Ariza, Miguel Ángel de Gregorio; Gamboa, Pablo; Gimeno, María José Pena; Alfonso, E.R.; Mainar, Ana M.; Medrano, J.; Lopez-Marin, P.; Tobio, R.; Herrera, Marcos

doi:10.1007/s00330-002-1489-9

Cited by 75 publications

(28 citation statements)

References 57 publications

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“…We found 10 reports that included 145 patients with benign SVC syndrome; 59.1% of those cases were associated with indwelling intravascular catheters or pacemaker wires (Table I). [3][4][5][6][7][8][9][10][11][12] As more patients undergo long-term treatment with indwelling catheters or cardiac devices with external leads, this trend is expected to continue.…”

Section: Discussionmentioning

confidence: 99%

“…In the 10 series we reviewed, the weighted average of clinical success was 95.5%. [3][4][5][6][7][8][9][10][11][12] The follow-up intervals varied among the studies, but during an average of 23.1 months, the primary patency rate was 66.2%, and the secondary rate was 93%. Only 5.2% of the patients had a complication, and most were minor; they included access-site hematoma 12 and asymptomatic stent migration.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular Stenting in 2 Patients with Benign Superior Vena Cava Syndrome

Hooker¹,

Hawkins²,

Abu‐Fadel³

2018

Texas Heart Institute Journal

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Superior vena cava syndrome has typically been associated with malignant conditions; however, the number of benign cases has started to grow as the use of upper-extremity venous lines and implantable cardiac devices increases. Whereas endovascular techniques are standardly used to treat patients with malignancies, the optimal care of patients with benign causes is less clear because they typically have longer life expectancies. We describe 2 cases of benign superior vena cava syndrome successfully managed with endovascular stenting, and we review the relevant literature. Of 145 cases in 10 series (average follow-up time, 24 mo), 96% of patients experienced symptomatic relief after endovascular management, with a primary patency rate of 66% and a secondary rate of 93%. Although few data exist to compare open surgical and endovascular techniques directly, both approaches appear to produce similar rates of patency. Both approaches frequently necessitate secondary intervention to maintain patency, but endovascular management is associated with fewer complications. We conclude that endovascular management of benign superior vena cava syndrome is a safe, effective, and reasonable initial management approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular Stenting in 2 Patients with Benign Superior Vena Cava Syndrome

Hooker¹,

Hawkins²,

Abu‐Fadel³

2018

Texas Heart Institute Journal

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“…Occasionally, and depending on the underlying condition, other rare therapeutic modalities might be undertaken. Examples include: SVC metallic stent placement [17], or surgical SVC reconstruction using autologous tissue [18].…”

Section: Discussionmentioning

confidence: 99%

“…It is always important to apply deep venous thrombosis preventive measures, according to current guidelines, especially for patients at higher risk for VTE [19]. Finally, some authors advocate thrombophilia screening in selected populations, such as Eastern Mediterranean or Hispanic, where these forms of genetic mutations are prevalent [8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Massive SVC Thrombus in a Woman With Heterozygous Methyl-Tetrahydrofolate Reductase A1298C Genetic Mutation

Waness¹

2012

J Hematol

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Some genetic mutations are known to be thrombophilic. Methyltetrahydrofolate reductase (MTHFR) mutations are among the most recently described. Further, large Superior Vena Cava thrombi are a rare occurrence. They are usually discovered in the setting of invasive venous procedures or in patients afflicted with malignancies. Their presentation can be dramatic in the form of Superior Vena Cava Syndrome requiring urgent therapeutic intervention. We present a unique case of a covert large Superior Vena Cava thrombus in a woman diagnosed with heterozygous Methyl-tetrahydrofolate reductase A1298C genetic mutation. She presented with symptoms of bilateral pulmonary embolism requiring urgent thrombolytic intervention. A discussion about the prevalence of Superior Vena Cava thrombi, their risk factors, their possible presentations, diagnostic modalities and therapeutic options follows the presentation.

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“…Stenting of the SVC had been performed before in small series [12, 13] and the results were similar when compared to that of surgery [14]. Both balloon‐expandable and self‐expanding stents had been used successfully in the management of SVC obstruction with good outcome [15, 16]. Balloon‐expandable stents have more radial strength and are stiffer than self‐expanding stents of identical design [17].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous treatment of superior vena cava obstruction following transvenous device implantation

Bolad

Karanam

Mathew

et al. 2005

Cathet Cardio Intervent

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The aim of this study is to assess the feasibility and safety of percutaneous treatment of superior vena cava (SVC) obstruction following transvenous device implantation. SVC obstruction is an uncommon but serious complication that can occur following permanent pacemaker or cardioverter defibrillator implantation utilizing transvenous endocardial leads. The treatment has traditionally been surgical but with the advent of stents, percutaneous approach is becoming popular. We report on the prevalence of SVC obstruction and the safety of its percutaneous catheter-based treatment. This is a retrospective study of SVC obstruction following device implantation in our institution from January 1993 through November 2003. A total of 1,850 permanent pacemaker and 1,200 implantable cardioverter defibrillator initial implants were performed during that period. Three patients developed SVC obstruction following implant (prevalence, 1/1,000 implant). Two patients were males and the mean age at implant was 57 +/- 13 years. Laser lead extraction and SVC angioplasty with or without stenting were performed in all patients. In two of them, this was followed by reimplantation of new systems. There were no procedural complications or mortality. The patients remain free of SVC obstruction symptoms 24 +/- 19 months after treatment. SVC obstruction prevalence after device implantation is low. Percutaneous treatment of SVC obstruction can be safely performed and appears to be effective in maintaining medium-term patency.

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Percutaneous treatment of superior vena cava syndrome using metallic stents

Cited by 75 publications

References 57 publications

Endovascular Stenting in 2 Patients with Benign Superior Vena Cava Syndrome

Endovascular Stenting in 2 Patients with Benign Superior Vena Cava Syndrome

Massive SVC Thrombus in a Woman With Heterozygous Methyl-Tetrahydrofolate Reductase A1298C Genetic Mutation

Percutaneous treatment of superior vena cava obstruction following transvenous device implantation

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