Subacute and chronic benign superior vena cava obstructions: endovascular treatment with self-expanding metallic stents.

Qanadli, Salah D.; Hajjam, Mostafa El; Mignon, F; Kerviler, É. de; Rocha, P; Barré, Olivier; Chagnon, S; Lacombe, Pascal

doi:10.2214/ajr.173.1.10397119

Cited by 102 publications

(75 citation statements)

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“…1 The SVC syndrome occurs more frequently today than in the past decade because more patients now require endovascular devices such as central venous catheters and pacemaker leads. 2 Occlusion of proximal veins af- ter the placement of such devices is a serious complication that may result in pulmonary embolism or the SVC syndrome. 4 The occlusion is caused primarily by vascular trauma from the indwelling central catheter or a pacemaker lead and by the progressive arterialization of the drainage vein of a hemodialysis fistula, in which increased flow may induce hyperplasia of the intima, followed by focal sclerosis and eventually venous thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…Obstruction of the large veins in the superior mediastinum may be caused by external compression (eg, by aortic aneurysms), thrombosis, direct invasion by tumor masses, various forms of mediastinitis, vascular trauma related to central venous catheters, and permanent pacemakers. [1][2][3] Regardless of its cause, the obstruction of major veins may affect functional capacity of the limbs, result in SVC syndrome, and cause substantial morbidity. Treatment may vary by the primary pathology and the patient's clinical status.…”

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confidence: 99%

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Color doppler sonographic finding of retrograde jugular venous flow as a sign of innominate vein occlusion

Conkbayir

Men

Yanık

et al. 2002

J of Clinical Ultrasound

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Occlusion or stenosis of the superior vena cava, the innominate vein, or both is an important clinical problem that requires prompt diagnosis. To confirm a suspected occlusion, imaging studies revealing the obstruction and the presence of collateral venous routes are needed. Color Doppler sonography (CDUS) is widely used to evaluate suspected venous thrombosis and collateral pathways. We present the CDUS findings in 2 cases of innominate vein occlusion. In case 1, CDUS of the neck and left upper arm, which harbored a permanent hemodialysis access, showed engorged veins in the upper arm, a patent dialysis access, and some collateral veins in the axilla. The subclavian and internal jugular veins were patent, but the flow in the left internal jugular vein was reversed. The left innominate vein was occluded. In case 2, CDUS of the upper arms showed that the veins, the dialysis access in the left upper arm, and the subclavian and jugular veins were patent, but the flow in the left internal jugular vein and in the right subclavian vein was reversed. Collateral veins were seen in the right axillary region. Both innominate veins were occluded. The resulting collateral pathways, ie, retrograde flow in the ipsilateral jugular vein crossing to the contralateral jugular vein through dural sinuses, were confirmed by venography in both cases.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Color doppler sonographic finding of retrograde jugular venous flow as a sign of innominate vein occlusion

Conkbayir

Men

Yanık

et al. 2002

J of Clinical Ultrasound

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show abstract

“…For this reason and in the presence of blood clots, angioplasty and stent are justified [11]. Stent deployment is an established option for benign CTV stenosis [17][18][19][20]. Stents are also particularly useful in rigid, distorted, and collapsing stenoses and in treatment of vessel injuries after recannalization as well as in extrinsic fibrotic compression [21].…”

Section: Discussionmentioning

confidence: 99%

Placement of Hemodialysis Catheters Through Stenotic or Occluded Central Thoracic Veins

Haller

Déglise

Saucy

et al. 2009

Cardiovasc Intervent Radiol

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A method for hemodialysis catheter placement in patients with central thoracic venous stenosis or occlusion is described and initial results are analyzed. Twelve patients, with a mean age of 63.2 years (42-80 years), with central venous stenosis or occlusion, and who required a hemodialysis catheter were reviewed. All lesions were confirmed by helical CT or phlebography. Five patients had stenosis while seven patients were diagnosed with an occlusion of thoracic central veins. All patients were asymptomatic, without sign of superior vena cava syndrome. After percutaneous transstenotic catheterization or guidewire-based recannalization in occlusions, a balloon dilatation was performed and a stent was placed, when necessary, prior to catheter placement. Technical success was 92%. Three patients had angioplasty alone and nine patients had angioplasty with stent placement. Dialysis catheters were successfully inserted through all recannalized accesses. No immediate complication occurred, nor did any patient develop superior vena cava syndrome after the procedure. The mean follow-up was 21.8 months (range, 8-48 months). Three patients developed a catheter dysfunction with fibrin sheath formation (at 7, 11, and 12 months after catheter placement, respectively). Two were successfully managed by percutaneous endovascular approach and one catheter was removed. In conclusion, for patients with central venous stenosis or occlusion and those who need a hemodialysis catheter, catheter insertion can be reliably achieved immediately after endovascular recannalization with acceptable technical and long-term success rates. This technique should be considered as an alternative procedure for placing a new hemodialysis catheter through a patent vein.

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“…The primary disease is lung cancer in more than 80 % of cases [7 -10]. Benign causes, such as catheter thromboses or strictures following radiation, are significantly rarer [11]. In the over 55 000 new cases of lung cancer predicted in Germany in 2016, it must be assumed that superior vena cava syndrome is already present in 3 -5 % of patients at the time of initial diagnosis or will develop over the course of the underlying disease [12,13].…”

Section: Materials Und Methodenmentioning

confidence: 99%

Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause

Büstgens

Loose

Ficker

et al. 2017

Fortschr Röntgenstr

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Purpose?The purpose of this paper is the retrospective analysis of endovascular therapy for the treatment of superior vena cava syndrome (SVCS) of malignant cause. This study focuses on the effectiveness of the therapy regarding the duration of remission, symptom control and practicability. Materials and Methods?From January 2003 to November 2012, therapeutic implantation of one or more stents was performed in 141 patients suffering from SVCS.?The medical history was retrospectively researched using digitalized patient files. If those were incomplete, secondary research was conducted using the cancer registry of the General Hospital Nuremberg, the cancer registry of the tumor center at Friedrich-Alexander-University Erlangen-Nuremberg (FAU) or information given by physicians in private practice. This data was collected using Microsoft Office Excel? and statistically analyzed using IBM SPSS Statistics 22?. Results?168 stents were implanted in 141 patients (median age: 64.6?years; range: 36???84), 86 being male and 55 being female. In 121 patients, SVCS was caused by lung cancer (85.8?%), in 9 patients by mediastinal metastasis of an extrathoracic carcinoma (6.4?%), in 3?patients by mesothelioma of the pleura (2.1?%) and in 1 patient by Hodgkin?s disease (0.7?%). There was no histological diagnosis in 7?cases (4.9?%). The primary intervention was successful in 138 patients (97.9?%). Immediate thrombosis in the stent occurred in the remaining 3 cases. Recurrence of SVCS was observed in 22 patients (15.6?%), including 5 early and 17 late occlusions. Stent dislocation or?breakage was not observed. As expected, the survival after implantation was poor. The median survival was 101 days, and the median occlusion-free survival was 80 days. Conclusion?The symptomatic therapy of SVCS with endovascular stents is effective and safe. Despite effective symptom control and a low rate of recurrence, the patients' prognosis is poor. Key Points:? Citation Format

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Subacute and chronic benign superior vena cava obstructions: endovascular treatment with self-expanding metallic stents.

Cited by 102 publications

References 0 publications

Color doppler sonographic finding of retrograde jugular venous flow as a sign of innominate vein occlusion

Color doppler sonographic finding of retrograde jugular venous flow as a sign of innominate vein occlusion

Placement of Hemodialysis Catheters Through Stenotic or Occluded Central Thoracic Veins

Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause

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