title: Endovascular recanalization of a port catheter-associated superior vena cava syndrome.
abstract: OBJECTIVE
  Superior vena cava (SVC) syndrome owing to benign etiology is rare and endovascular techniques have been advocated as the treatment of choice. We report a case of endovascular revascularization of a port catheter-associated complete occlusion of the SVC with reversed flow in the azygos vein.
  
  
  METHODS
  In this setting using a sheath in combination with its dilatator to pass the occlusion of the SVC after neither a diagnostic catheter nor a PTA balloon would pass the lesion may be a valid option. A dual venous approach was established using the right common femoral vein and an indwelling port catheter in the right cephalic vein to dilate and stent the lesion. Finally, a port may be implanted after the revascularization had been successful.
  
  
  RESULTS
  Passage through the port catheter-associated occlusion of the SVC was only possible by use of the sheath in combination with its dilatator. A dual venous access by the femoral approach and the indwelling central catheter is helpful in treating a SVC occlusion.
  
  
  CONCLUSIONS
  Long-term central venous catheters may cause SVC syndrome, especially with a catheter tip located too far cranially. An endovascular revascularization of a complete occlusion of the SVC represents the therapy of choice.
authors.affiliation: 1 Department of Radiology, Neuroradiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck - Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Tonak
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fetscher
authors.forename: Jörg
authors.initials: J
authors.lastname: Barkhausen
authors.forename: Jan Peter
authors.initials: JP
authors.lastname: Goltz
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001401:Azygos Vein / Q000503:physiopathology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D062905:Central Venous Catheters; D020878:Device Removal; D057510:Endovascular Procedures; D004867:Equipment Design; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy*; D008297:Male; D010690:Phlebography; D012039:Regional Blood Flow; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000503:physiopathology
chemical_list: D000970:Antineoplastic Agents