Percutaneous endovascular management of chronic superior vena cava syndrome of benign causes : long-term follow-up

Breault, Stéphane; Doenz, Francesco; Jouannic, Anne-Marie; Qanadli, Salah D.

doi:10.1007/s00330-016-4354-y

Cited by 51 publications

(48 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,4) For patients without a fistula, recurrence free survival with endovascular intervention was 91% at 1 year and 73% at 3 years. 5) Assisted patency of the SVC system was 100% at 1 and 3 years. 5) Furthermore, in our case, the failure of the Denver catheter was caused by both SVC thrombosis and intracatheter thrombosis.…”

Section: Discussionmentioning

confidence: 96%

“…5) Assisted patency of the SVC system was 100% at 1 and 3 years. 5) Furthermore, in our case, the failure of the Denver catheter was caused by both SVC thrombosis and intracatheter thrombosis. Although in the past, surgical removal and replacement were needed in this situation, the endovascular intervention we performed (intra-catheter balloon dilations and a Fogarty-like procedure) was also effective in eliminating the intra-catheter thrombosis and in completing immediate recanalization with good results.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Endovascular Treatment of Concomitant Obstructions of a Denver Drainage Catheter and Superior Vena Cava in a Patient With Liver Cirrhosis

et al. 2017

View full text Add to dashboard Cite

SummaryWith the increased use of intravascular catheters and devices, they have become the major non-malignant cause of superior vein cava (SVC) syndrome. We report a patient with liver cirrhosis who had received a peritoneovenous drainage catheter for refractory ascites, and then developed SVC syndrome because of concomitant occlusions of both the SVC and the drainage catheter. The patient regained patency of both the occluded vessel and the drainage catheter through percutaneous transluminal venoplasty, and there was dramatic improvement of clinical symptoms and good performance of the drainage catheter. Percutaneous intervention may be a feasible and effective therapy for SVC syndrome and intra-catheter thrombosis-related dysfunction. (Int Heart J 2017; 58: 447-450) Key words: Superior vein cava syndrome, Percutaneous intervention, Angioplasty, Indwelling catheters S uperior vena cava (SVC) syndrome is characterized by stenosis or occlusion of the SVC leading to venous congestion of the venous drainage territory affecting the head, neck, upper extremities, and upper chest. The most common cause of SVC syndrome is external compression by malignancies. However, with their increased use, intravascular catheters and devices have become the major non-malignant cause of SVC syndrome.1) Herein, we report a patient with liver cirrhosis who had received a peritoneovenous drainage catheter for refractory ascites, and developed SVC syndrome because of concomitant occlusions of both the SVC and the drainage catheter. The patient regained patency of both the occluded vessel and the drainage catheter by means of percutaneous transluminal venoplasty, and showed a dramatic improvement in clinical symptoms with good performance of the drainage catheter thereafter. Case ReportA 50-year-old male, with known alcoholic liver cirrhosis, stage C in the Child-Pugh classification, who had undergone implantation of a peritoneovenous shunt (Denver shunt) for refractory ascites 4 years before this event, was referred to our cardiovascular department due to progressive swelling of the face and bilateral upper arms, dyspnea on exertion, and increasing waist circumference for 4 months. The Child-Pugh stage had deteriorated from his usual stage B to stage C (11 points: albumin: 2.1 g/dL, total bilirubin: 0.5 mg/dL, prothrombin time prolongation: 6.1 seconds, ascites: severe, no hepatic encephalopathy). A high level of D-dimer (1740 μg/L, normal cut-off value: 550 μg/L) was found and contrast-enhanced chest computed tomography revealed that a huge thrombus had caused complete obstruction of the SVC, which also involved the tip of the Denver catheter. The result was malfunction of the peritoneovenous shunt and blood drainage of the upper venous system through the azygous and collateral veins ( Figures 1A and 1B). With the diagnosis of SVC syndrome, intravenous heparin and oral Coumadin were initiated. Biochemical analyses of coagulation/fibrinolytic factors (protein C, protein S, antithrombin III, fibrinogen, factor V Leiden, factor VIII, ...

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Endovascular Treatment of Concomitant Obstructions of a Denver Drainage Catheter and Superior Vena Cava in a Patient With Liver Cirrhosis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…An attempt at endovascular treatment of intracranial hypertension resulting from stenosis or occlusion of the venous system was based on widely available publications regarding the efficacy of such treatment strategies. [1][2][3][4] Because no clear recommendations are available regarding covered and uncovered stent placement, we decided to insert an uncovered Zilver Vena, a dedicated venous stent, at the SVC recanalization site. Although Haddad et al 5 suggested higher effectiveness of covered stents, they also emphasized the need for further studies in this area.…”

Section: Discussionmentioning

confidence: 99%

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

Nowakowski

Buszman

Kiesz

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

An Arnold-Chiari malformation is a congenital central nervous system defect. Raised intracranial pressure is commonly observed, and posterior decompression neurosurgery is the treatment of choice. We describe a patient with iatrogenic occlusion of bilateral jugular veins, subclavian vein, and superior vena cava resulting from repeated central venous cannulations. Because of venous hypertension, the patient suffered from neurologic symptoms: headaches, vision disturbances, and marked head edema. Two stents were used to recanalize the right internal jugular vein and superior vena cava. Symptoms subsided, and the patient returned to work. During 24-month follow-up, stents were patent. The patient remains symptom free and continues working. (J Vasc Surg Cases and Innovative Techniques 2020;6:18-20.)

show abstract

“…For recanalization of mature thrombus or nonthrombotic obstruction, less invasive methods (eg, softer guide wires and dilators, noncompliant angioplasty balloons) should be attempted before more aggressive techniques and devices (eg, sharp recanalization, cutting balloons, stent insertion) are employed, although risk‐benefit analysis and the experience of the procedural team will ultimately govern these decisions. Without long‐term outcomes data for venous stents in children, they should be used with caution and restraint …”

Section: Failure Points and Essential Components Of Carementioning

confidence: 99%

“…Without long-term outcomes data for venous stents in children, they should be used with caution and restraint. [141][142][143] Although evidence for high morbidity and mortality in children with venous catheter-related DVT is compelling, 8,144,145 until recently, data favoring anticoagulation for CVC-related thrombi and infection prophylaxis have been relatively weak. 146 Evidence regarding the effectiveness of a shorter duration of therapy and selective use is evolving.…”

Section: Catheter-related Thrombosis and Venous Obstructionmentioning

confidence: 99%

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

Baskin

Mermel

Saad

et al. 2019

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Children with chronic illness often require prolonged or repeated venous access. They remain at high risk for venous catheter–related complications (high‐risk patients), which largely derive from elective decisions during catheter insertion and continuing care. These complications result in progressive loss of the venous capital (patent and compliant venous pathways) necessary for delivery of life‐preserving therapies. A nonstandardized, episodic, isolated approach to venous care in these high‐need, high‐cost patients is too often the norm, imposing a disproportionate burden on affected persons and escalating costs. This state‐of‐the‐art review identifies known failure points in the current systems of venous care, details the elements of an individualized plan of care, and emphasizes a patient‐centered, multidisciplinary, collaborative, and evidence‐based approach to care in these vulnerable populations. These guidelines are intended to enable every practitioner in every practice to deliver better care and better outcomes to these patients through awareness of critical issues, anticipatory attention to meaningful components of care, and appropriate consultation or referral when necessary.*

show abstract

Percutaneous endovascular management of chronic superior vena cava syndrome of benign causes : long-term follow-up

Cited by 51 publications

References 41 publications

Endovascular Treatment of Concomitant Obstructions of a Denver Drainage Catheter and Superior Vena Cava in a Patient With Liver Cirrhosis

Endovascular Treatment of Concomitant Obstructions of a Denver Drainage Catheter and Superior Vena Cava in a Patient With Liver Cirrhosis

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

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

Contact Info

Product

Resources

About