title: Management of superior vena cava syndrome by internal jugular to femoral vein bypass.
abstract: 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.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, PIN, India.
authors.forename: Rajinder Singh
authors.initials: RS
authors.lastname: Dhaliwal
authors.forename: Debasis
authors.initials: D
authors.lastname: Das
authors.forename: Suvitesh
authors.initials: S
authors.lastname: Luthra
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Singh
authors.forename: Sudhir
authors.initials: S
authors.lastname: Mehta
authors.forename: Harkant
authors.initials: H
authors.lastname: Singh
mesh_terms: 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
chemical_list: D011138:Polytetrafluoroethylene