Self-expandable metallic stent therapy for superior vena cava syndrome: clinical observations.
OBJECTIVE
To study clinical and physiologic aspects of Z-stent therapy for superior vena cava (SVC) syndrome secondary to malignant disease.


METHODS
Signs and symptoms of SVC syndrome were classified, graded, and scored in 11 cases. Six patients with caval pressure higher than 22 mm Hg peripheral to the stenosis underwent stent therapy.


RESULTS
Immediately after Z-stent implantation into the stenotic lesion, the diameter of the constriction increased from 3.3 mm +/- 2.0 (mean +/- standard deviation) to 14.0 mm +/- 3.2, the mean caval pressure peripheral to the stenosis decreased from 26.6 mm Hg +/- 2.5 to 8.9 mm Hg +/- 0.7, and the symptom score decreased from 6.7 +/- 1.8 to 1.3 +/- 1.4. The caval pressure, lesion diameter, and symptom score correlated highly with each other. One complication--transient pulmonary edema attributable to volume overload caused by reperfusion--was observed. Mean survival exceeded 7.1 months.


CONCLUSIONS
Stent placement could be a useful treatment for refractory SVC syndrome.
Kishi
K
K
Department of Radiology, Saiseikai Wakayama Hospital, Japan.
Sonomura
T
T
Mitsuzane
K
K
Nishida
N
N
Yang
R J
RJ
Sato
M
M
Yamada
R
R
Shirai
S
S
Kobayashi
H
H
D000368:Aged; D016280:Atrial Function, Right / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002404:Catheterization; D002496:Central Venous Pressure / Q000502:physiology; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015642:Radiology, Interventional; D013193:Stainless Steel; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000473:pathology
D013193:Stainless Steel