Treatment of superior and inferior vena cava syndromes of malignant cause with Wallstent catheter placed percutaneously.
Superior vena cava syndrome (SVCS) and inferior vena cava syndrome (IVCS) represent a severe symptomatic complication of some malignant tumors. Although radiation therapy and chemotherapy are elective, symptomatic relief takes 7-10 days to be achieved, and poor symptomatic benefit can be obtained in relapsed or resistant tumors. We report on a palliative approach using Wallstent catheters placed percutaneously in a series of 16 patients. Results obtained in relief of symptoms were excellent (complete response of cephalea, jugular enlargement, and collateral circulation achieved in 100% [16/16] of patients; complete response of edema obtained in 93% [15/16] of patients). Achievement of symptomatic response was obtained for all symptoms during the first 24 h poststenting, except for edema and dyspnea. Mean duration of patency of the stents was 6.4 months (range 2-17 months). Rates of morbidity and complications were very low. Dyspnea was a quite resistant symptom, and only four of 13 patients (31%) obtained complete response, while partial improvement was obtained in the other nine (79%). However, placement of the stents does not preclude the use of radiation therapy or chemotherapy. We think that these results and those from other studies warrant larger multicentric trials.
Chacón López-Muñiz
J I
JI
Medical Oncology Service, Hospital Virgen de la Salud, Toledo, Spain.
García García
L
L
Lanciego Pérez
C
C
Cruz Mora
M A
MA
García Peris
A
A
Martínez Martínez
B
B
López Gómez
L
L
D000368:Aged; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000209:etiology* / Q000628:therapy*; D016019:Survival Analysis; D013899:Thoracic Neoplasms / Q000150:complications*; D013997:Time Factors; D014654:Vascular Patency; D014682:Vena Cava, Inferior