Superior Vena Cava Syndrome

Azizi, Abdul Hussain; Shafi, Irfan; Shah, Neal; Rosenfield, Kenneth; Schainfeld, DO Robert; Sista, Akhilesh K.; Bashir, Riyaz

doi:10.1016/j.jcin.2020.08.038

Cited by 61 publications

(77 citation statements)

References 57 publications

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“…The findings of our systematic review lend credence to ET as first-line treatment for SVC syndrome as it provides a rapid resolution of symptoms, high technical success, low restenosis and recurrence rates, with low intra- and post-procedural complications. Generally, SVC obstruction is categorized into four types using the Stanford and Doty Classification system based on major venographic patterns with each type associated with progressively advanced obstruction and development of collateral venous systems [4] . Nine studies reported using the Stanford and Doty Classification system ( Table 1 ), but the studies did not report primary outcomes based on the classification.…”

Section: Discussionmentioning

confidence: 99%

“…SVC syndrome affects ~15,000 patients in the United States annually [1] . Malignancies such as primary lung cancer are the most common cause accounting for 70% of cases but the recently increased utilization of indwelling intravascular devices such as catheters, and pacemaker/defibrillator leads have led to a rise in device-related SVC syndrome [2] , [3] , [4] . Consensus guidelines for SVC syndrome are lacking, however, traditionally treatment approach has included radiation therapy (RT) with or without chemotherapy, surgical bypass, or endovascular therapy (ET) [5] .…”

Section: Introductionmentioning

confidence: 99%

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Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis

et al. 2021

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Background: Superior vena cava (SVC) syndrome is caused by the obstruction of the SVC and can result in significant morbidity and mortality. In contemporary practice, endovascular therapy (ET) has become the standard of care for a majority of these patients. This study is a systematic review and meta-analysis of the available literature to assess technical success, restenosis, and recurrence of SVC syndrome following endovascular intervention. Methods: For this meta-analysis, we conducted a systematic literature review of PubMed, Cochrane Library, and Embase databases from inception to April 14, 2021 for studies on ET for SVC syndrome. Studies included full-length journal articles on the use of ET among adults with SVC syndrome. Case reports or case series with fewer than 20 patients were excluded. We evaluated the endpoints of technical success rate, restenosis rate, and recurrence rates in SVC syndrome patients after endovascular stenting. The results of this study were calculated using random-effects models. Findings: We identified 6,012 reports, of which 39 studies met our inclusion criteria and were included for analysis. A total of 2200 patients received ET for SVC syndrome. The weighted technical success rate was 98.8% (95% CI 98.2À99.3) with low heterogeneity (I 2 =17.4%, p = 0.185), restenosis rate was 10.5% (95% CI 8.4À12.6) with moderate heterogeneity (I 2 =53.5%, p<0.001), and recurrence rate was 10.8% (95% CI 8.1À13.5) with high heterogeneity (I 2 =75.8%, p<0.001). Total complication rate was 8.6% (95% CI 7.3%-9.9%) with a mean complication rate of 7.5% (95% CI 4.7%-10.3%). Interpretation: Our systematic review revealed high technical success, low restenosis, and low recurrence rates following ET. Collectively, these results support the paradigm of ET as an effective and safe treatment for patients with SVC syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis

et al. 2021

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“…The incidence of SVC syndrome is 2-4% in lung cancer patients and up to 10% in SCLC patients (155). When SVC syndrome causes laryngeal and cerebral edema and hemodynamic instability, urgent endovascular stenting is required (156).…”

Section: Interventional Treatment Of Svc Syndromementioning

confidence: 99%

International consensus on severe lung cancer—the first edition

Zhou¹,

Li²,

Li³

et al. 2021

Transl Lung Cancer Res

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“…Superior vena cava (SVC) syndrome is caused by partial or complete occlusion of the SVC, and in recent years, the incidence of device-related SVC syndrome has risen because of modern-day use of catheters, pacemakers, and defibrillators. At present, device-related SVC syndrome accounts for up to 40% of all cases ( 1 ). Patients commonly present with facial and chest edema, dyspnea and cough, and nonpulsatile distended neck veins ( Figure 1 ).…”

mentioning

confidence: 99%

“…Patients commonly present with facial and chest edema, dyspnea and cough, and nonpulsatile distended neck veins ( Figure 1 ). Depending on the severity and location of the obstruction and the presence of collateral venous drainage, patients may also experience varying degrees of neurological (eg, headache, blurred vision), laryngopharyngeal (eg, glossitis), and upper extremity (eg, edema) sequelae ( 1 ). In this case series, we report 3 cases of SVC syndrome following implantation of the percutaneous dual-lumen ProTek Duo (Tandem Life) right ventricular assist device (RVAD).…”

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confidence: 99%