J Korean Med Sci.  2004 Aug;19(4):519-522. 10.3346/jkms.2004.19.4.519.

Endovascular Stenting as a First Choice for the Palliation of Superior Vena Cava Syndrome

• Kim YI
• Kim KS
• Ko YC
• Park CM
• Lim SC
• Kim YC
• Park KO
• Yoon W
• Kim YH
• Kim JK
• Ahn SJ

• KMID: 2157679
• DOI: http://doi.org/10.3346/jkms.2004.19.4.519

Abstract

To assess the effectiveness of endovascular stenting for the palliation of superior vena cava (SVC) syndrome, endovascular stent insertion was attempted in 10 patients with symptomatic occlusion of the SVC. All the patients had known malignant disease of the thorax. Eight patients had been treated previously with chemotherapy and radiotherapy (n=5), chemotherapy alone (n=2), or pneumonectomy and radiotherapy (n=1). After developing SVC syndrome, all the patients were stented before receiving any other treatment. After single or multiple endovascular stents were inserted, five of eight patients were treated with chemotherapy and radiotherapy (n=2) or chemotherapy alone (n=3). Resolution of symptoms was achieved in nine patients within 72 hr (90%). In one patient, the symptoms did not disappear until a second intervention. At follow up, symptoms had recurred in two of ten patients (20%) after intervals of 15 and 60 days. Five patients have died from their cancers, although they remained free of symptoms of SVC occlusion until death. In conclusion, endovascular stent insertion is an effective treatment for palliation of SVC syndrome. Endovascular stent insertion can be considered the first choice of treatment, due to the immediate relief of symptoms and excellent sustained symptomatic relief.

Keyword

Superior Vena Cava Syndrome; Stents; Lung Neoplasms

MeSH Terms

Adult
Female
Humans
Male
Middle Aged
*Palliative Care
Retrospective Studies
*Stents
Superior Vena Cava Syndrome/etiology/pathology/*therapy
Thoracic Neoplasms/complications/pathology
Treatment Outcome

Figure

• 

  Fig. 1 (A) Venous Doppler of superior vena cava demonstrating near total obstruction (arrowheads) in the first stent (arrows), 2 weeks after the first procedure. (B) Fluoroscopic images show sequence of procedure for placement and balloon dilatation of 6 cm×14 mm the second stent through the first stent, across the lesion. (C) Radiography showing two stents placement, after the second procedure. Arrow and arrowhead indicate the upper ends of the second and first stent respectively.

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