Endovascular stenting as a first choice for the palliation of superior vena cava syndrome.
To assess the effectiveness of endovascular stenting for the palliation of superior vena cava (SVC) syndrome, endovascular stent insertion was attempted in 10 patients with symptomatic occlusion of the SVC. All the patients had known malignant disease of the thorax. Eight patients had been treated previously with chemotherapy and radiotherapy (n=5), chemotherapy alone (n=2), or pneumonectomy and radiotherapy (n=1). After developing SVC syndrome, all the patients were stented before receiving any other treatment. After single or multiple endovascular stents were inserted, five of eight patients were treated with chemotherapy and radiotherapy (n=2) or chemotherapy alone (n=3). Resolution of symptoms was achieved in nine patients within 72 hr (90%). In one patient, the symptoms did not disappear until a second intervention. At follow up, symptoms had recurred in two of ten patients (20%) after intervals of 15 and 60 days. Five patients have died from their cancers, although they remained free of symptoms of SVC occlusion until death. In conclusion, endovascular stent insertion is an effective treatment for palliation of SVC syndrome. Endovascular stent insertion can be considered the first choice of treatment, due to the immediate relief of symptoms and excellent sustained symptomatic relief.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Yu-Il
YI
Kim
Kyu-Sik
KS
Kim
Young-Chun
YC
Ko
Chang-Min
CM
Park
Sung-Chul
SC
Lim
Young-Chul
YC
Kim
Kyung-Ok
KO
Park
Woong
W
Yoon
Yoon-Hyun
YH
Kim
Jae-Kyu
JK
Kim
Sung-Ja
SJ
Ahn
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013899:Thoracic Neoplasms / Q000150:complications / Q000473:pathology; D016896:Treatment Outcome