title: "The Scalpel or the Needle for Superior Vena Cava syndrome"?
abstract: Acute Superior Vena Cava (SVC) syndrome from thrombosis is an increasingly recognized complication of intravascular devices. We present a 31 year old woman with an infusion port placed for chemotherapy who developed acute SVC obstruction. A computerized tomograpy (CT) of chest revealed an occlusive thrombus within the SVC extending into the right atrium. Catheter-guided thrombolysis and surgical thrombectomywere felt to impose prohibitive risks. Worsening symptoms led to the use of systemic thrombolysis with tissue plasminogen activator (t-PA) leading to dramatic improvement in symptoms. A repeat CT revealed a reduction of the right atrial thrombus and SVC occlusion had resolved.
authors.forename: Deepak
authors.initials: D
authors.lastname: Chandra
authors.forename: Naga Venkata K
authors.initials: NV
authors.lastname: Pothineni
authors.forename: Nikhil
authors.initials: N
authors.lastname: Meena
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D062666:Vascular Access Devices / Q000009:adverse effects*
chemical_list: D010959:Tissue Plasminogen Activator