Superior vena cava syndrome (SVCS), which is characterized by facial edema and congestion
of the head, upper extremities, and neck, is a life-threatening oncologic emergency.
Although a combination of chemotherapy and radiation therapy has been considered as the
standard treatment for SVCS, stent implantation to the superior vena cava (SVC) has been
recently developed to alleviate edema or dyspnea caused by SVCS. On the other hand, stent
implantation to the SVC requires skilled interventional cardiologists or radiologists. In
general, those specialists reside in university hospitals or large hospitals in an urban
area. In this case report, an 86-year-old man underwent stent implantation to a stenosed
SVC in a rural area. Because the patient refused the transfer to the core, urban hospital,
we invited a skilled interventional cardiologist from the core hospital and performed
stent implantation to the SVC in a small, rural hospital. It is generally difficult to
perform stent implantation for SVCS in a small hospital, because skilled operators in the
field of interventional cardiology or radiology do not usually perform operations in
smaller facilities. Our case indicates the importance of cooperation between rural
generalists and urban specialists.
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