Self-Expanding Metal Stents for Palliative Treatment of Superior Vena Caval Syndrome

Oudkerk, M.; Kuijpers, T. J. A.; Schmitz, Paul; Loosveld, Olaf; Wit[cf11]3, Ronald de

doi:10.1007/s002709900032

Cited by 8 publications

(12 citation statements)

References 9 publications

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“…Other stent types had 78–100% success rates in relieving the venous stenosis 15 30 – 33. Reports for multiple stents used within the same institution achieved similar results 10 13 15 18 21 34. Thus the experience of the interventional radiologist is the key to achieving good results.…”

Section: Methodsmentioning

confidence: 95%

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Safety and effectiveness of vascular endoprosthesis for malignant superior vena cava syndrome

Nguyen

Borok²,

Welsh

et al. 2009

Thorax

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Background: Superior vena cava syndrome management has been traditionally radiation therapy, chemotherapy or chemoradiation, depending on the underlying malignancy involved and individual clinicopathological features of the case. Recent emergence of endovascular stents offer the opportunity for immediate relief of the venous stenosis. This review examines findings from the published series which used endovascular prosthesis for this syndrome with regards to efficacy and safety. Methods: Literature search identified studies using endovascular stents as initial therapy or for recurrence of malignant superior vena cava syndrome. Effectiveness and toxicity from stent placement was assessed. Results: Endovascular stent placement provides immediate haemodynamic relief of venous compression either before or after definitive therapy in the majority of cancer patients. Severe bleedings, cardiopulmonary complications and stent migrations remain significant problems for patient management. Conclusions: Endovascular prosthesis is an effective modality for malignant superior vena cava syndrome with acceptable morbidity. Prospective studies should be performed to determine the optimal anticoagulation regimen.

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Section: Methodsmentioning

confidence: 95%

“…Occult cerebral metastases may also explain brain haemorrhage during fibrinogen lysis 28. Massive haemoptysis may also occur during thrombolytic therapy34 or during maintenance anticoagulation therapy 20. Paraneoplastic hypercoagulation state combined with the presence of a foreign body increased the risk of thrombosis after stent placement.…”

Section: Methodsmentioning

confidence: 99%

Safety and effectiveness of vascular endoprosthesis for malignant superior vena cava syndrome

Nguyen

Borok²,

Welsh

et al. 2009

Thorax

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“…Then in 1986, Charnsangavej et al 2 first reported employing the Gianturco stent in two patients, one with superior vena cava syndrome and the other with retroperitoneal fibrosis that obstructed the inferior vena cava (IVC), which resulted in immediate relief of the presenting symptoms. [3][4][5][6][7] The Japanese Society for the Study of Metallic Stents also reported that 149 Gianturco stents were placed in the venous system of patients in Japan between 1987 and 1993. [3][4][5][6][7] The Japanese Society for the Study of Metallic Stents also reported that 149 Gianturco stents were placed in the venous system of patients in Japan between 1987 and 1993.…”

Section: Introductionmentioning

confidence: 99%

Gianturco stents for the venous system: A detailed pathological study

et al. 1998

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This study was designed to examine the short-term performance of Gianturco stents placed in the venous system, in comparison with that of stents placed in the arterial system. Single-bodied modified Gianturco stents were surgically placed in six dogs (group 1), while in another six dogs, only exposure of the vessels was performed (group 2). Segments with an outer diameter 0.9 times smaller than those of the stents were targeted in the infrarenal inferior vena cava (IVC), the portal vein (PV), and the infrarenal abdominal aorta (AA). The animals were killed 4 weeks postoperatively for pathological analysis. All the segments were patent in both groups. Although the stents placed in the infrarenal IVC and PV were completely covered with neointima, those placed in the infrarenal AA were only partially covered. Furthermore, the venous stents were deeply embedded in the media, while the aortic stents remained in the intima. Medial hyperplasia occurred in the venous stents, while intimal hyperplasia occurred in the aortic stents. In conclusion, Gianturco stents placed in the IVC and PV performed better in the short term than the stents placed in the AA.

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“…A completa resolução da síndrome é relatada em 68 a 100% dos casos 12,[22][23][24][25] . O sucesso clínico do tratamento varia de 55 26 a 93% 12 .…”

Section: Discussionunclassified

“…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 . Nos pacientes com lesões associadas à hemodiálise, a taxa de reestenose varia de 60 a 80% 27 .…”

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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Self-Expanding Metal Stents for Palliative Treatment of Superior Vena Caval Syndrome

Abstract: The overall clinical success rate for long-term patency was 100% for the Z-stents and 69% for the new Wallstent. These results suggest that when used for this purpose, the new Wallstent is more thrombogenic at 2 weeks than the Z-stent.

Cited by 8 publications

References 9 publications

Safety and effectiveness of vascular endoprosthesis for malignant superior vena cava syndrome

Safety and effectiveness of vascular endoprosthesis for malignant superior vena cava syndrome

Gianturco stents for the venous system: A detailed pathological study

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

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