[Endovascular treatment of superior vena cava syndrome]

Michel Bergoeing R, Renato Mertens M, Francisco Valdés E, Albrecht Krämer Sch, Manuel Alvarez Z, Pablo Bertin C, Rodrigo Sagüés C, Eric Orellana U, Héctor Galindo A, Jeannette Vergara G, Magaly Valdebenito C
Revista Médica de Chile 2006, 134 (7): 827-32

BACKGROUND: Superior vena cava syndrome (SVCS) is caused by the obstruction of venous drainage from the upper portion of the body. Common clinical findings are headache and cervical, facial and upper limb edema. Occasionally, clouding of consciousness appears.

AIM: to report our experience with endovascular treatment of SVCS.

MATERIAL AND METHODS: Retrospective review of all patients with SVCS subjected to endovascular treatment between 1999 and 2005.

RESULTS: Eight patients were treated, all of them with malignancies. Six had a benign obstruction due to the presence of a chemotherapy catheter located in the superior vena cava, one had obstruction secondary to radiation therapy and one a tumor compression of the superior vena cava. Two patients underwent thrombolytic therapy. Angioplasty and stenting was performed in all patients. The chemotherapy catheter was removed to all patients and installed again in one. One patient had a hemothorax secondary to a simultaneous needle lung biopsy under video thoracoscopy. No patient died in relation to the procedure. Congestive signs and symptoms subsided in all patients within 24 hours after the procedure. During follow up, only one patient had symptoms related to vena cava obstruction and three died due to their malignant tumor.

CONCLUSIONS: Endovascular treatment of SVCS has a low rate of complications and provides immediate and mid-term symptom relief.

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