Safety and Efficacy of Stent Graft Implantation for Malignant Superior Vena Cava Syndrome

Abstract

Background: Patients with malignant superior vena cava syndrome (SVCS) usually require urgent treatments due to a high potential risk of early mortality. Stent implantation can rapidly improve the symptoms of SVCS, which may be beneficial to subsequent anti-tumor therapy. The aim of the study was to evaluate the clinical outcomes of stent graft implantation for the treatment of superior vena cava (SVC) obstruction caused by non-small cell lung carcinoma (NSCLC) with acute post-stenting occlusion. Methods: Between October 2014 and December 2019, 16 patients were selected for stent graft implantation. Technical success and clinical efficacy were assessed. Stent patency and patient survival rates, as well as the complications were analyzed. Results: There were 17 stent grafts implanted in 16 patients. The technical success was 100%. The residual stenosis after initial implantation was 64.0 ± 9.0%. The stent expanded to an optimal size in 5.5 ± 2.2 days after the initial deployment. Migration occurred when deploying of the stent graft in one patient; this stent graft was successfully stabilized by a second one. No other complications related to the procedure were found except one migration. At 1, 3, 6, 9 and 12 months, the cumulative survival rates were 100%, 75%, 56%, 19% and 0%, respectively. The mean OS was 173 days. The median survival was 166 days. Conclusions: Stent graft can be safely used in patients with SVC obstruction with a good long-term patency rate.

Palliativmedizinische Aspekte der Pneumo-Onkologie

“…Bei chemotherapiesensitiven Erkrankungen wie dem kleinzelligen Lungenkarzinom und geringer Symptomlast kann der Effekt der Chemotherapie abgewartet werden. In allen anderen Fällen sollte die Implantation eines Cava-Stents erwogen werden, welche meist unmittelbar zu einem Rückgang der Symptomatik führt [29,30].…”