The Role of Stenting the Superior Vena Cava Syndrome in Patients With Malignant Disease

Abstract

Superior vena cava (SVC) obstruction occurs in patients with intrathoracic malignancies. Clinical symptoms can be distressing but presentation is insidious. We investigated the outcome of endovascular management for patients with SVC syndrome. We retrospectively reviewed the case histories of 17 patients (9 men) from January 2003 to June 2009. All patients had malignant disease. There were 24 interventions (2 patients with 2 interventions and 2 patients with 3 interventions). All had SVC stenosis over 90%. All patients were treated with intrathoracic angioplasty and stenting. All procedures were technically successful, and all patients had insertion of 10 to 18 mm diameter stents with symptom resolution in 16 patients. There were 2 occlusions at 1 and 6 weeks and 2 patients with restenosis (3 and 7 months). Endovascular intervention is technically feasible for SVC occlusion, relieves symptoms, and is a useful palliation measure.

Percutaneous Endovascular Y-Stenting of a Malignant Superior Vena Cava and Innominate Vein Obstruction

“…The role of endovascular stenting in alleviating obstructive symptoms is well established in intrathoracic malignancies. 9 Often, however, these patients have already received maximal adjunct therapies, and further oncological treatment (for recurrence) is not possible. 10 However, there are yet no data available in its efficacy synchronic obstructions of the SVC and IV.…”

Endovascular Stenting in Superior Vena Cava Syndrome: A Systematic Review and Meta-analysis

“…Anticoagulation medications used included warfarin, aspirin, heparin, antiplatelets and their combinations. Three studies comprising 142 patients stated that neither intra-procedural nor long-term anticoagulation was attempted [3,20,34].…”

Superior Vena Cava Syndrome in the Cancer Patient: A Case Study

“…If the cancer prognosis for the patient is poor, then it would be appropriate to relieve symptoms and offer comfort measures. In most cases where SVCS is caused by a malignancy, chemotherapy or radiation is the treatment of choice (Cho, Janho, & Mohan, 2011). Vascular thrombosis may require thrombolytic agents.…”

“…Endovascular management is another well-recognized treatment for malignant SVCS. A stent is placed in the SVC to increase the blood flow through the stenosis (Cho et al, 2011).…”