title: Endovascular stenting in neoplastic superior vena cava syndrome prior to chemotherapy or radiotherapy.
abstract: BACKGROUND
  The standard conventional palliative treatment of choice for patients with neoplastic superior vena cava syndrome (SVCS) is chemotherapy, radiotherapy or surgery. In our study, palliative stenting was used as a first-line therapeutic measure in all cases using self-expanding stents prior to any antitumour therapy.
  
  
  METHODS
  17 patients, 10 men and 7 women, all of whom presenting with the clinical diagnosis of SVCS confirmed by phlebography combined with CT, were referred for stenting of the superior caval vein. All procedures were performed after local anaesthesia without sedatives or general anaesthesia in the angiosuite at the radiology department. Symptom response was evaluated directly after the procedure at several intervals by clinical and nursing staff.
  
  
  RESULTS
  19 self-expanding Symphony stents were successfully implanted in 15 of 17 cancer patients with SVCS in a period of five years. All 15 individuals remained free from SVCS after the successful stenting procedure. No stent-related complications occurred.
  
  
  CONCLUSIONS
  This study demonstrates that palliative SVC stenting prior to any antitumour therapy is feasible, easily performed without serious complications and provides a quicker symptom response than obtained with radiation therapy or chemotherapy alone. Primary stenting also provides the opportunity to establish a correct diagnosis before starting antitumour therapy.
authors.affiliation: Departments of' Radiology, St. Elisabeth Hospital, Tilburg, The Netherlands. ebierdrager@flevoziekenhuis.nl
authors.forename: E
authors.initials: E
authors.lastname: Bierdrager
authors.forename: L E H
authors.initials: LE
authors.lastname: Lampmann
authors.forename: P N M
authors.initials: PN
authors.lastname: Lohle
authors.forename: C M
authors.initials: CM
authors.lastname: Schoemaker
authors.forename: J H E M
authors.initials: JH
authors.lastname: Schijen
authors.forename: F M L H G
authors.initials: FM
authors.lastname: Palmen
authors.forename: C
authors.initials: C
authors.lastname: van der Heul
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D010166:Palliative Care; D010690:Phlebography; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior