title: Large-bore nitinol stents for malignant superior vena cava syndrome: factors influencing outcome.
abstract: OBJECTIVE
  The purpose of this article is to retrospectively evaluate the technical and clinical outcomes of large-bore nitinol stents for treating malignant superior vena cava syndrome. In addition, we analyzed factors potentially influencing the outcome.
  
  
  METHODS
  Over a 7-year period, 78 consecutive patients presented with superior vena cava syndrome related to primary lung tumor (n=62) or malignant lymphadenopathies (n=16). The factors analyzed were Kishi score at admission, tumor type, and need for an additional balloon-expandable stent.
  
  
  RESULTS
  Technical success was obtained in all but one patient (99%), who presented with a stent migration immediately after insertion. In 17 patients (22%), an additional balloon-expandable stent was needed for complete expansion of the nitinol stent. For patients with symptomatic malignant lymphadenopathies or primary lung tumor, overall survival rates were 50% (n=8) and 54% (n=34), respectively, at 6 months and 19% (n=3) and 34% (n=21), respectively, at 12 months (p=0.376). There was no difference in survival as a function of the Kishi score (p=0.80) or of the placement of an additional balloon-expandable stent (p=0.35). Finally, reocclusion events were noted in patients both with (n=1) and without (n=7) a balloon-expandable stent.
  
  
  CONCLUSIONS
  Large-bore nitinol stents are highly effective for malignant superior vena cava syndrome. The survival rates of patients with caval vein stenosis due to either the primary tumor or secondary enlarged adenopathies were equal. An additional balloon-expandable stent was required in 22% of cases owing to incomplete expansion of the nitinol stent but was not associated with higher thrombosis rate.
authors: Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. geert.maleux@uzleuven.be
authors: Geert
authors: G
authors: Maleux
authors: Patrick
authors: P
authors: Gillardin
authors: Steffen
authors: S
authors: Fieuws
authors: Sam
authors: S
authors: Heye
authors: Johan
authors: J
authors: Vaninbroukx
authors: Kristiaan
authors: K
authors: Nackaerts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000792:Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol