[Superior vena cava syndrome].
Superior vena cava syndrome is due to an intrinsic or extrinsic caval obstruction that evolves in acute or subacute way with distinctive clinical feature such as respiratory symptoms and venous stasis. Since 1998 we have treated three cases of spontaneous superior vena cava thrombosis in neoplastic patients who underwent several infusion of chemotherapy, respectively for a breast, uterine and rectum cancer. All patients was female, 52, 58 and 70 years old. The first two cases was treated with locoregional thrombolysis by infusing Urokinase 50,000 UI/h during 24 hours and Urokinase 50,000 UI/h during 12 h the third one. After that, we have positioned a 16/9 wallstent: in the first two cases directly into the superior vena cava, in the third case in the subclavian-anonyma truncus. We had in all cases the complete opening of the stent within the first 48 hours without complications, enabling us to reach a free caval diameter of about 2 cm with resolution of the clinical signs. In patients with high surgical risk, the caval wall-stent is the first choice to solve the vein recanalization.
Stagnitti
F
F
Università degli Studi La Sapienza, Roma Istituto di Clinica Chirurgica d'Urgenza e di Pronto Soccorso.
Mongardini
M
M
Coletti
M
M
Calderale
S M
SM
Ribaldi
S
S
Salvi
P F
PF
Schillaci
F
F
Bresadola
L
L
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010960:Plasminogen Activators / Q000008:administration & dosage; D011859:Radiography; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage; D014656:Vascular Surgical Procedures / Q000379:methods
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator