Endovascular treatment of superior vena cava obstruction in patients with malignancies

• 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
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s003300050777

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.