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Background and objectiveSuperior vena cava syndrome (SVCS) is caused by venous return obstruction often originated by an invading mediastinal tumour. Our objective was to evaluate the usefulness of stents as initial treatment for SVCS of malignant origin.Patients and methodsFrom December 1996 to August 2010, 120 patients with SVCS were referred for percutaneous treatment. Seventy-six were under oncological follow-up cases and in 44 cases the tumour was unknown. A non-concurrent prospective study was made of 113 patients without prior chemotherapy or radiotherapy, who opted for endovascular treatment as first option.ResultsOne hundred and two men and 11 women were treated, mean age 61.18 years old (range 45-85). SVCS causes included lung cancer (100), lung metastases (6), compression by enlarged lymph nodes (6), and an embryonic tumour. One hundred and fifty-five prostheses were implanted. One stent was enough in 75 patients, 2 stents in 34, and 3 in 4. Technical success rate was 98.2%. Symptoms disappeared completely in 97 patients and partially in 13. Complications were stent migration (5), epistaxis (1), and post-procedure groin hematoma (1). Seventy-three asymptomatic patients had a mean survival of 210 days (75% primary permeability and 52.9% secondary permeability).ConclusionsThe use of stents in malignant SVCS is a safe and effective procedure for venous obstruction, leading to the immediate disappearance of symptoms, allowing the underlying tumour staging, facilitating the establishment of the best treatment and improving life quality.

Original publication

DOI

10.1016/j.medcli.2011.11.012

Type

Journal article

Journal

Medicina clinica

Publication Date

01/2013

Volume

140

Pages

59 - 65

Addresses

Servicio de Radiodiagnóstico, Hospital General Universitario de Valencia, Valencia, España. talens_ama@gva.es

Keywords

Humans, Neoplasms, Germ Cell and Embryonal, Mediastinal Neoplasms, Lung Neoplasms, Lymphatic Metastasis, Superior Vena Cava Syndrome, Hematoma, Prosthesis Failure, Tomography, X-Ray Computed, Treatment Outcome, Palliative Care, Retrospective Studies, Prospective Studies, Stents, Aged, Aged, 80 and over, Middle Aged, Female, Male, Endovascular Procedures