[Venous angioplasty and Wallstent implantation in emergency treatment of superior vena cava syndrome caused by tumor].
METHODS
A 58-year-old man was hospitalized because of threatened asphyxia resulting from massive obstruction to neck vein flow and increased venous markings over the ventral and dorsal thorax. The previous year he had received radiotherapy (total of 55.8 Gy) for squamous cell carcinoma in the right upper lobe of the lung (primary stage T2 N2 M0). The signs of venous congestion had developed over several months.


METHODS
Emergency phlebography demonstrated obstruction to superior vena cava (SVC) flow by tumour compression.


METHODS
It was possible to pass the SVC obstruction with a hydrophilic guide-wire and then perform a balloon angioplasty, followed later by implantation of two intraluminal expandable stents ("Wallstent"). The dyspnoea quickly improved after the successful recanalization. The day after the intervention palliative radiotherapy of the SVC obstruction was begun. But increased venous markings over the thorax recurred, but without dyspnoea, after 4 1/2 months free of signs of venous congestion. Repeat phlebography again demonstrated complete obstruction of the SVC by the tumour. Recanalization by balloon angioplasty was again achieved.


CONCLUSIONS
This case underlines the value of percutaneous balloon angioplasty with stent implantation as supplementary treatment in the late stages of SVC obstruction by tumour.
Köhler
F
F
Medizinische Klinik und Poliklinik I, Charité, Humboldt-Universität Berlin.
Romaniuk
P
P
Witt
C
C
Stockheim
D
D
Mergenthaler
H G
HG
Grunewald
R
R
Baumann
G
G
D000800:Angioplasty, Balloon; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D004630:Emergencies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010690:Phlebography; D012008:Recurrence; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D014683:Vena Cava, Superior