Management of superior vena cava syndrome by internal jugular to femoral vein bypass.
We report a 30-year-old man with superior vena cava syndrome due to fibrosis from a previously irradiated malignant thymoma. The patient presented 4 years after the initial treatment, after having been lost to follow-up. Investigations revealed total obstruction of the superior vena cava, and right subclavian and right internal jugular vein. The patient underwent an extra-anatomic bypass (ringed polytetrafluoroethylene graft 10-mm diameter) between the left internal jugular vein and the left femoral vein brought in a subcutaneous tunnel over the anterior chest and abdominal wall. Entry to the thoracic cavity was avoided due to extensive fibrotic changes visualized in the computed tomographic chest scan. Follow-up Doppler at 2 months, 6 months, 1 year, and 3 years showed a patent graft. An internal jugular vein to the femoral vein bypass is a simple method for palliation of superior vena cava syndrome.
Dhaliwal
Rajinder Singh
RS
Department of Cardiovascular and Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, PIN, India.
Das
Debasis
D
Luthra
Suvitesh
S
Singh
Jaswinder
J
Mehta
Sudhir
S
Singh
Harkant
H
D000328:Adult; D019917:Blood Vessel Prosthesis Implantation; D005268:Femoral Vein / Q000601:surgery*; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery*; D008297:Male; D010166:Palliative Care; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects; D013348:Subclavian Artery / Q000473:pathology; D013479:Superior Vena Cava Syndrome / Q000601:surgery*; D013945:Thymoma / Q000532:radiotherapy; D013953:Thymus Neoplasms / Q000532:radiotherapy
D011138:Polytetrafluoroethylene