Endovascular treatment of superior vena cava obstruction in patients with malignancies

The aim of this study was to report our experience on the management of superior vena cava obstruction (SVCO) secondary to malignant disease, using endovascular procedures. Twenty-six patients with SVCO due to primary or secondary tumors of the lung or the mediastinum, or catheter inserted for treat...

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Bibliographic Details
Published in:European radiology 1999-01, Vol.9 (5), p.965-971
Main Authors: Thony, F, Moro, D, Witmeyer, P, Angiolini, S, Brambilla, C, Coulomb, M, Ferretti, G
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon
Catheterization, Central Venous - adverse effects
Catheters
Female
Humans
Male
Medical procedures
Middle Aged
Radiography, Interventional
Stents
Superior Vena Cava Syndrome - diagnostic imaging
Superior Vena Cava Syndrome - etiology
Superior Vena Cava Syndrome - therapy
Thoracic Neoplasms - complications
Thrombolytic Therapy
Thrombosis - drug therapy
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Summary:The aim of this study was to report our experience on the management of superior vena cava obstruction (SVCO) secondary to malignant disease, using endovascular procedures. Twenty-six patients with SVCO due to primary or secondary tumors of the lung or the mediastinum, or catheter inserted for treatment of an extra-thoracic neoplasm, had an endovascular therapy which consisted of stenting, angioplasty, thrombo-aspiration or local fibrinolysis. Immediately after the procedure, rapid relief of symptoms occurred in 24 (90 %) of the patients. The mean Kishi's score decreased from 5.5 to 0.96. Immediate complications included one death related to pericarditis bleeding following fibrinolysis. Three patients relapsed after 20 days, 4 months and 6 months, and needed a second stenting. At 6 months the primary patency rate was 83 % and the secondary patency rate was 89 %. Endovascular treatment of SVCOs is a simple and safe procedure to restore the patency of the superior vena cava in malignant SVCO. It should be indicated in most cases as first-line treatment and performed as early as possible.
ISSN:0938-7994
1432-1084
DOI:10.1007/s003300050777