title: Bridging stent placement through the superior vena cava to the inferior vena cava in a patient with malignant superior vena cava syndrome and an iodinated contrast material allergy.
abstract: Positioning is critical during the placement of superior vena cava (SVC) stents in patients with malignant SVC syndrome. Although SVC stents effectively relieve various symptoms of SVC syndrome, improper stent positioning may cause life-threatening complications such as migration that result in fatal cardiac failure. Here we describe a patient with an allergy to iodinated contrast material (ICM) who presented with SVC syndrome owing to mediastinal lymph node metastases from hepatocellular carcinoma, which was successfully treated with an SVC stent. Secure stent placement was achieved by bridging the stent through the SVC to the inferior vena cava with venography using carbon dioxide instead of ICM.
authors.affiliation: Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan, dokamoto@med.kyushu-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okamoto
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sone
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shibamoto
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sugawara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tomimatsu
authors.forename: Shinichi
authors.initials: S
authors.lastname: Morita
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
chemical_list: D003287:Contrast Media