[Local thrombolysis with stent implantation in a patient with vena cava superior syndrome].
BACKGROUND
Vena cavasuperior syndrome is a well-known complication to ventriculoatrial shunts in children and adults. The basis for this is thrombosis.


METHODS
A patient with hydrocephalus had a ventriculoatrial shunt in his first month of life. More than 30 years later he developed vena cava superior syndrome following abdominal surgery. Diagnostic venography revealed thrombosis in the proximal veins of his arms, neck and vena cava superior.


CONCLUSIONS
He was treated with catheter-directed thrombolysis with antegrade infusion of alteplase (Actilyse). Evaluation of thrombolytic treatment after one day revealed a significant stenosis in the superior caval vein in the same area as the shunt had ended. Venoplasty and stent implantation were performed, and an intraluminal diameter of 10 mm was reached. Complete thrombolysis was achieved after 48 hours' infusion of alteplase. His swellings subsided the following two weeks and control venography 6 months later showed no signs of rethrombosis or restenosis. His life-threatening condition was successfully treated with local thrombolytic therapy, venoplasty and stent implantation.
Vik
Anders
A
Medisinsk avdeling, Universitetssyhuset Nord-Norge, Tromsø. anders.vik@unn.no
Kumar
Satish
S
Singh
Kulbir
K
Hansen
John-Bjarne
JB
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D000925:Anticoagulants; D010959:Tissue Plasminogen Activator