Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome (original) (raw)
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Fast-Track Management of Malignant Superior Vena Cava Syndrome
CardioVascular and Interventional Radiology, 2004
We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.
Percutaneous stent placement in malignant cases of superior vena cava syndrome
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
Superior vena cava (SVC) syndrome is caused by SVC stenosis or occlusion, frequently as a consequence of lung cancer or a mediastinal tumor. SVC syndrome is characterized by unpleasant symptoms and the condition usually leads to death if untreated. Treatment with radiation therapy and chemotherapy may produce an initial relief, whereas operations with bypass are associated with high mortality and morbidity. The PURPOSE of our study was to show the efficiency of percutaneous stenting in the SVC for relieving SVC syndrome secondary to malignant diseases. From January 1999 to March 2003, 17 patients with malignant SVC syndrome were evaluated at the "Metaxa" Cancer Hospital. Their caval stenoses were confirmed by means of computed tomography and venography. There were 15 males and 2 females with a median age of 62 years (range 47-79). The SCV syndrome was caused by malignant disease in all patients: bronchogenic carcinoma in 14 and lymphoma in 3. All patients underwent placeme...
American Journal of Roentgenology, 2009
exceeds 90%. It is common to observe 46% efficacy for RT in non-small cell lung carcinoma (NSCLC) and 62-80% for chemotherapy in patients with small cell lung carcinoma (SCLC) [6, 7]. The use of chemotherapy and RT in combination is controversial and is currently under revision because of the many side effects and the low response rates (mean survival at 2 years = 5%) [7]. Placement of endovascular stents to manage SVC syndrome and inferior vena cava syndrome has been used over the past 15 years as an additional tool for the palliative treatment of these patients [8-14]. To date, most of the patient series described in the literature consider the use of stents to be a coadjuvant treatment with RT or chemotherapy if there had been little or no response to RT or chemotherapy or if the clinical syndrome recurred after conventional treatment. Earlier this decade, however, some investigators suggested that stents may be used as the
CardioVascular and Interventional Radiology, 2011
Purpose To demonstrate the effectiveness of endovascular treatment (EVT) with self-expandable bare stents for malignant superior vena cava syndrome (SVCS) and to analyze predictive factors of EVT efficacy. Methods Retrospective review of the 164 patients with malignant SVCS treated with EVT in our hospital from August 1992 to December 2007 and followed until February 2009. Endovascular treatment includes angioplasty before and after stent placement. We used self-expandable bare stents. We studied results of this treatment and looked for predictive factors of clinical efficacy, recurrence, and complications by statistical analysis. Results Endovascular treatment was clinically successful in 95% of cases, with an acceptable rate of early mortality (2.4%). Thrombosis of the superior vena cava was the only independent factor for EVT failure. The use of stents over 16 mm in diameter was a predictive factor for complications (P = 0.008). Twenty-one complications (12.8%) occurred during the follow-up period. Relapse occurred in 36 patients (21.9%), with effective restenting in 75% of cases. Recurrence of SVCS was significantly increased in cases of occlusion (P = 0.01), initial associated thrombosis (P = 0.006), or use of steel stents (P = 0.004). Long-term anticoagulant therapy did not influence the risk of recurrence or complications. Conclusion In malignancy, EVT with self-expandable bare stents is an effective SVCS therapy. These results prompt us to propose treatment with stents earlier in the clinical course of patients with SVCS and to avoid dilatation greater than 16 mm.
Superior Vena Cava Syndrome: A Palliative Approach to Treatment
Cureus
Superior vena cava (SVC) syndrome is an oncologic emergency of venous congestion due to impaired venous flow through the SVC to the right atrium, leading to potential hemodynamic instability. We report a case of a 78-year-old female patient with a non-symptomatic lung nodule that exhibited rapid growth from its discovery to an enlarging tumor impinging the SVC in less than one month. The short time span from computed tomography (CT) image of the tumor to oncologic emergency required our team to act quickly to identify the source of the tumor and halt its progression, utilizing a multidisciplinary team approach while dealing with a patient that executed their right of autonomy to refusal of care, thus focusing on management with palliative goals since SVC syndrome has a life expectancy of six months post-diagnosis.
Tumoral Superior Vena Cava Syndrome: About 19 Cases
SAS Journal of Medicine
Introduction: Superior vena cava syndrome (SCS) results from obstruction of the superior vena cava and/or its brachiocephalic collaterals by extrinsic compression and/or by tumor or cruoric thrombosis. The aim of this work is to draw up the clinical, radiological and therapeutic profile of SCV linked to cancers whatever their histological types. Materials and methods: This is a retrospective study carried out at the Military Hospital Mohamed V -Rabat-, over a period of seven years, from January 1, 2011 to December 31, 2017. We included all the patients with histologically confirmed cancers, complicated by SCS. Results: 16 men and 3 women with cancer presented with SCS during the study period. Their average age was 53 years old. The SCS was indicative of neoplastic pathology in 63% of cases. The most common etiology was lung cancer (58%). The majority of patients received symptomatic treatment (oxygen therapy and corticosteroid therapy). Anticoagulant treatment at curative doses was ...