title: Endovascular treatment of superior vena cava obstruction in patients with malignancies.
abstract: The aim of this study was to report our experience on the management of superior vena cava obstruction (SVCO) secondary to malignant disease, using endovascular procedures. Twenty-six patients with SVCO due to primary or secondary tumors of the lung or the mediastinum, or catheter inserted for treatment of an extra-thoracic neoplasm, had an endovascular therapy which consisted of stenting, angioplasty, thrombo-aspiration or local fibrinolysis. Immediately after the procedure, rapid relief of symptoms occurred in 24 (90 %) of the patients. The mean Kishi's score decreased from 5.5 to 0.96. Immediate complications included one death related to pericarditis bleeding following fibrinolysis. Three patients relapsed after 20 days, 4 months and 6 months, and needed a second stenting. At 6 months the primary patency rate was 83 % and the secondary patency rate was 89 %. Endovascular treatment of SVCOs is a simple and safe procedure to restore the patency of the superior vena cava in malignant SVCO. It should be indicated in most cases as first-line treatment and performed as early as possible.
authors.affiliation: Department of Radiology and Medical Imaging, CHU A Michallon, BP 217, F-38043 Grenoble Cedex 09, France.
authors.forename: F
authors.initials: F
authors.lastname: Thony
authors.forename: D
authors.initials: D
authors.lastname: Moro
authors.forename: P
authors.initials: P
authors.lastname: Witmeyer
authors.forename: S
authors.initials: S
authors.lastname: Angiolini
authors.forename: C
authors.initials: C
authors.lastname: Brambilla
authors.forename: M
authors.initials: M
authors.lastname: Coulomb
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002405:Catheterization, Central Venous / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D013899:Thoracic Neoplasms / Q000150:complications; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy