Superior vena cava stenting in the 21st century

Abstract

Superior vena cava obstruction (SVCO) is most commonly due to malignant or thrombotic causes. The traditional treatments of surgery, radiotherapy or chemotherapy either have a high morbidity and mortality rate, or a lag period of a few weeks prior to response. Superior vena cava stenting is able to provide rapid relief of symptoms safely in the vast majority of patients. It has now become the first-line treatment for malignant SVCO, and is increasingly being used in benign SVCO. The complication and success rates compare very favourably with the other treatment modalities.

Iatrogenic occlusion of bilateral jugular veins, subclavian vein, and superior vena cava after repeated jugular cannulation associated with Arnold-Chiari malformation: Successful endovascular treatment

“…Fortunately, repeated endovascular treatment is possible. 6,7 There is no consensus with respect to effective anticoagulant therapy for prevention of stent thrombosis after SVC recanalization. Oral anticoagulants or antiplatelet agents are typically used for several months.…”

“…No comparative studies are yet available to analyze both strategies in this group of patients. [6][7][8][9] The antithrombotic regimen used in our patient during a 30-day follow-up (ie, low-molecular-weight heparin and dual antiplatelet therapy) resulted from our experience in endovascular treatment of arterial disease and thrombosis prevention. Aggressive management was associated with the extent of recanalization and stent length exceeding 120 mm.…”

Outcome and Management of Pacemaker‐Induced Superior Vena Cava Syndrome

“…Stenting should be considered in these circumstances. Stent placement is now the first‐line treatment for malignant SVC obstruction to establish long‐term venous patency, and it is increasingly being used in benign SVC obstruction . Stent placement across existing leads in patients with pacemaker‐related SVC syndrome has been described in small case series .…”

Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

“…Balloon angioplasty and stent implantation are valid and reliable methods to treat stenoses of the SVC successfully [6]. It has become the first-line treatment of obstructions of the SCV and the success and complication rates are very promising [7]. …”