Cargando…

Superior vena cava syndrome: endovascular management

BACKGROUND: The objective of management of superior vena cava syndrome (SVCS) is to promptly alleviate the uncomfortable symptoms. Conventional approaches do not always achieve results as rapidly as endovascular management with stent placement. OBJECTIVES: To report the experience with endovascular...

Descripción completa

Detalles Bibliográficos
Autores principales: Karakhanian, Walter Kegham, Karakhanian, Walter Zavem, Belczak, Sergio Quilici
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774659/
https://www.ncbi.nlm.nih.gov/pubmed/31616492
http://dx.doi.org/10.1590/1677-5449.180062
_version_ 1783456110110310400
author Karakhanian, Walter Kegham
Karakhanian, Walter Zavem
Belczak, Sergio Quilici
author_facet Karakhanian, Walter Kegham
Karakhanian, Walter Zavem
Belczak, Sergio Quilici
author_sort Karakhanian, Walter Kegham
collection PubMed
description BACKGROUND: The objective of management of superior vena cava syndrome (SVCS) is to promptly alleviate the uncomfortable symptoms. Conventional approaches do not always achieve results as rapidly as endovascular management with stent placement. OBJECTIVES: To report the experience with endovascular management of SVCS of a Vascular and Endovascular Surgery Service at a Brazilian university hospital. METHODS: Symptomatic type III SVCS cases were managed with angioplasty and stent placement in 28 patients aged from 37 to 68 years, between 2002 and 2012. The etiology of SVCS was lung or thoracic cancer in 18 patients, while occlusion of the vein for prolonged use of catheters was the cause in the other 10 cases. RESULTS: Superior vena cava occlusion repair was not possible in one oligosymptomatic patient with a very severe lesion. Technical success was achieved in 96.4%. There were two deaths, one due to pulmonary embolism, 24 hours after a successful procedure, and the other due to compression of the airways by tumor mass some hours after the procedure. Clinical success was achieved in all cases of technical success, including one patient who died suddenly, after total regression of SVCS symptoms. Symptoms disappeared 24 hours and 48 hours after management in16 and 8 patients respectively; improvement was slower but progressive after 48 hours in the remaining patients. CONCLUSIONS: Endovascular stent placement was effective for management of SVCS, with good technical and clinical success rates and provided prompt relief from symptoms.
format Online
Article
Text
id pubmed-6774659
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
record_format MEDLINE/PubMed
spelling pubmed-67746592019-10-15 Superior vena cava syndrome: endovascular management Karakhanian, Walter Kegham Karakhanian, Walter Zavem Belczak, Sergio Quilici J Vasc Bras Original Article BACKGROUND: The objective of management of superior vena cava syndrome (SVCS) is to promptly alleviate the uncomfortable symptoms. Conventional approaches do not always achieve results as rapidly as endovascular management with stent placement. OBJECTIVES: To report the experience with endovascular management of SVCS of a Vascular and Endovascular Surgery Service at a Brazilian university hospital. METHODS: Symptomatic type III SVCS cases were managed with angioplasty and stent placement in 28 patients aged from 37 to 68 years, between 2002 and 2012. The etiology of SVCS was lung or thoracic cancer in 18 patients, while occlusion of the vein for prolonged use of catheters was the cause in the other 10 cases. RESULTS: Superior vena cava occlusion repair was not possible in one oligosymptomatic patient with a very severe lesion. Technical success was achieved in 96.4%. There were two deaths, one due to pulmonary embolism, 24 hours after a successful procedure, and the other due to compression of the airways by tumor mass some hours after the procedure. Clinical success was achieved in all cases of technical success, including one patient who died suddenly, after total regression of SVCS symptoms. Symptoms disappeared 24 hours and 48 hours after management in16 and 8 patients respectively; improvement was slower but progressive after 48 hours in the remaining patients. CONCLUSIONS: Endovascular stent placement was effective for management of SVCS, with good technical and clinical success rates and provided prompt relief from symptoms. Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2019-09-24 /pmc/articles/PMC6774659/ /pubmed/31616492 http://dx.doi.org/10.1590/1677-5449.180062 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Karakhanian, Walter Kegham
Karakhanian, Walter Zavem
Belczak, Sergio Quilici
Superior vena cava syndrome: endovascular management
title Superior vena cava syndrome: endovascular management
title_full Superior vena cava syndrome: endovascular management
title_fullStr Superior vena cava syndrome: endovascular management
title_full_unstemmed Superior vena cava syndrome: endovascular management
title_short Superior vena cava syndrome: endovascular management
title_sort superior vena cava syndrome: endovascular management
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774659/
https://www.ncbi.nlm.nih.gov/pubmed/31616492
http://dx.doi.org/10.1590/1677-5449.180062
work_keys_str_mv AT karakhanianwalterkegham superiorvenacavasyndromeendovascularmanagement
AT karakhanianwalterzavem superiorvenacavasyndromeendovascularmanagement
AT belczaksergioquilici superiorvenacavasyndromeendovascularmanagement