Large-Bore Nitinol Stents for Malignant Superior Vena Cava Syndrome: Factors Influencing Outcome

Maleux, Geert; Gillardin, Patrick; Fieuws, Steffen; Heye, Sam; Vaninbroukx, Johan; Nackaerts, Kristiaan

doi:10.2214/ajr.12.9582

Cited by 27 publications

(9 citation statements)

References 19 publications

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“…Comparisons of different clinical studies can be difficult, as there is inconsistent reporting of patient survival, clinical success, SVCS recurrence, stent type, and length of followup. However, all these studies showed high overall clinical success rates of 80%-95% with recurrence rates of 11%-28% for as long as 8 months of follow-up (8,12,21,24,25). Survival rate, technical success, clinical outcome, primary patency, and complications in the present study are all in agreement with data from the literature.…”

Section: Discussionsupporting

confidence: 91%

Endovascular Treatment of Malignant Superior Vena Cava Syndrome through Upper-Limb Access: A Comparison between Venous-Dedicated and Conventional Stents

Matthaiou

Galanakis

Kehagias

et al. 2020

Journal of Vascular and Interventional Radiology

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Purpose: To retrospectively evaluate the technical and clinical outcomes of superior vena cava (SVC) stent placement through upperlimb venous access in malignant SVC syndrome (SVCS) and compare the efficacy of different nitinol stent types. Materials and Methods: Between 2006 and 2018, 156 patients (132 male; mean age, 62 y; age range, 33-81 y) underwent SVC stent placement for malignant obstructions through upper-limb venous access with 1 of 3 types of nitinol stent: 1 venous-dedicated (Sinus-XL stent) and 2 non-venous-dedicated (E-Luminexx Vascular Stent and Prot eg e GPS). Cases of common femoral vein access or non-nitinol stents were excluded from further analysis. The mean duration of follow-up was 8 mo. Results: Technical success was achieved in 99.3% of cases. One patient died during the procedure as a result of cardiac tamponade. Balloon predilation was performed in 10 patients and postdilation in 126. Mean procedural time was 34.4 min (range, 18-80 min). Overall survival rates were 92.3%, 57.3%, and 26.8%, and overall primary patency rates were 94.5%, 84.8% and 79.6%, at 1, 6, and 12 mo, respectively. There were no statistically significant differences in primary patency rates between venous-and non-venous-dedicated stents or among different Stanford SVCS grading groups (P > .05). Conclusions: SVC stent placement through an upper-limb approach is a safe, fast, and effective technique. There is no evident benefit of venous-dedicated vs non-venous-dedicated stents in the treatment of malignant SVCS.

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Section: Discussionsupporting

confidence: 91%

Endovascular Treatment of Malignant Superior Vena Cava Syndrome through Upper-Limb Access: A Comparison between Venous-Dedicated and Conventional Stents

Matthaiou

Galanakis

Kehagias

et al. 2020

Journal of Vascular and Interventional Radiology

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“…Wei et al believe that although stents combined with targeted drugs as secondary SVCS treatment for lung cancer cannot prolong the survival of patients, they can bene t patients [13]. In this study, the success rate of stent implantation technology was 100%, and all patients' clinical symptoms were signi cantly relieved after surgery, which is similar to the results reported by Mokry, Maleux and Fagedet [14,15,16].…”

Section: Discussionsupporting

confidence: 84%

Percutaneous Transluminal Stenting for Superior Vena Cava Syndrome Caused by Malignant Tumors : A Single Center Retrospective Study

Liu

Wang

et al. 2020

Preprint

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Objectives：To evaluate the efficacy of percutaneous stent placement in the treatment of superior vena cava syndrome caused by malignant tumors.Methods：To retrospectively analyze the clinical data of 32 patients with superior vena cava syndrome who underwent percutaneous endovascular stent treatment in our department from 2015 to 2019 due to malignant tumors, and summarize the patient’s gender, age, tumor type, endovascular treatment plan, complications and postoperative follow-up.Results：All patients successfully underwent percutaneous intraluminal stent placement with digital subtraction angiography (DSA). Thirty seven endovascular stents were implanted in 32 patients, including 21 Eluminexx stents, 12 Wallstent stents, and 4 covered stents..The technical success rate was 100%, and there were no serious surgery-related complications.The remission rate of clinical symptoms was 53.1% (17 / 32) in 24 hours and 84.4% (27 / 32) in 48 hours. The follow-up period was 1.5-24 months, with an average follow-up period of 6.5 months. During the follow-up, 3 patients had re-stenosis and 1 patient had secondary thrombosis in the stent. The symptoms were relieved after the second treatment.Conclusion: For superior vena cava syndrome caused by malignant tumors, percutaneous endoluminal stent therapy can quickly and effectively relieve the clinical symptoms of patients, and the incidence of complications is low. It should be used as a first-line treatment.

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“…Today, stent placement is typically done using conscious sedation and local anesthesia, and can be performed as long as the patient can lie flat or semi-supine on the operating table (Watkinson et al 2008 ; Charnsangavej et al 1986 ). Stent placement is quite effective for symptom relief, with up to 97–99 % of patients experiencing rapid post-operative relief (Maleux et al 2013 ; Gwon et al 2013 ). Headache is typically relieved immediately after the procedure, facial edema typically resolves within 24 h, and upper extremity and truncal edema may last for up to 72 h after stent placement (Hennequin et al 1995 ; Rosch et al 1992 ).…”

Section: Non-rt Treatment Modalitiesmentioning

confidence: 99%

Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome

et al. 2016

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Superior vena cava syndrome (SVCS) is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. SVCS is a medical emergency if associated with laryngeal or cerebral edema. The etiologies and management of SVCS have evolved over time. Non-malignant SVCS is typically caused by infectious etiologies or by thrombus in the superior vena cava and can be managed with antibiotics or anti-coagulation therapy, respectively. Radiation therapy (RT) has long been a mainstay of treatment of malignant SVCS. Chemotherapy has also been used to manage SVCS. In the past 20 years, percutaneous stenting of the superior vena cava has emerged as a viable option for SVCS symptom palliation. RT and chemotherapy are still the only modalities that can provide curative treatment for underlying malignant etiologies of SVCS. The first experiences with treating SVCS with RT were reported in the 1970’s, and several advances in RT delivery have subsequently occurred. Hypo-fractionated RT has the potential to be a more convenient therapy for patients and may provide equal or superior control of underlying malignancies. RT may be combined with stenting and/or chemotherapy to provide both immediate symptom palliation and long-term disease control. Clinicians should tailor therapy on a case-by-case basis. Multi-disciplinary care will maximize treatment expediency and efficacy.

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Large-Bore Nitinol Stents for Malignant Superior Vena Cava Syndrome: Factors Influencing Outcome

Cited by 27 publications

References 19 publications

Endovascular Treatment of Malignant Superior Vena Cava Syndrome through Upper-Limb Access: A Comparison between Venous-Dedicated and Conventional Stents

Endovascular Treatment of Malignant Superior Vena Cava Syndrome through Upper-Limb Access: A Comparison between Venous-Dedicated and Conventional Stents

Percutaneous Transluminal Stenting for Superior Vena Cava Syndrome Caused by Malignant Tumors : A Single Center Retrospective Study

Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome

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