[Stent implantation for the palliative therapy of upper inflow obstruction in bronchial carcinoma].
OBJECTIVE
To analyse results obtained in the palliative treatment of obstruction of the upper inflow veins by stent implantation in patients with bronchial carcinoma.


METHODS
Stents were implanted in 14 patients with upper venous obstruction due to bronchial carcinoma (three women, eleven men: mean age 64 [48-74] years), 4 of the superior vena cava (SVC), 6 of the SVC and brachiocephalic vein, 4 of the SVC and subclavian vein. To prevent thromboembolic phenomena all patients received heparin in therapeutic doses for 1-3 days from the time of stents implantation.


RESULTS
Treatment was successful (regression of the clinical signs) in 12 of the 14 patients. Six patients died, without recurrence of the clinical signs, an average of 141 (10-420) days after the procedure. Mean survival time of the six patients who remained without symptoms was 3 months (longest interval 9 months). In one patient thrombotic occlusion of the SVC occurred 6 days after stent implantation. However, local thrombolysis successfully re-opened the vessel. Renewed upper vein obstruction occurred in two patients during follow-up. None of the stent filaments fractured and there was no stent dislocation.


CONCLUSIONS
With a success rate of 86% stent implantation proved to be a sparing procedure in the palliative treatment of upper inflow vein obstruction, especially in patients with extensive malignant disease.
Wilhelm
K
K
Radiologische Universitätsklinik, Bonn.
Schild
H
H
Textor
J
J
Mildenberger
P
P
Strunk
H
H
Terjung
B
B
Lorenz
J
J
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001984:Bronchial Neoplasms / Q000150:complications* / Q000401:mortality; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality; D018288:Carcinoma, Small Cell / Q000150:complications* / Q000401:mortality; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012008:Recurrence; D015607:Stents; D013350:Subclavian Vein; D013479:Superior Vena Cava Syndrome / Q000209:etiology / Q000601:surgery; D016019:Survival Analysis; D013923:Thromboembolism / Q000517:prevention & control; D014652:Vascular Diseases / Q000209:etiology / Q000601:surgery*
D000925:Anticoagulants; D006493:Heparin