title: Superior Vena Cava Obstruction Complicated by Upper Extremity Deep Vein Thrombosis: A Novel Endovascular Approach.
abstract: Superior vena cava obstruction (SVCO) and associated thrombus formation can occur in patients with upper mediastinal or right apical masses. While stenting is useful in relieving obstruction, it can facilitate the passage of upper extremity deep vein thrombus to the pulmonary arterial tree, resulting in a potentially fatal pulmonary embolism (PE). We present a case that illustrates a novel technique, which protects the patient from PE while also relieving the SVCO. This involves placing an inferior vena cava filter in an inverted position within a superior vena cava (SVC) stent to capture emboli. This procedure offers a potentially lifesaving endovascular therapeutic option to patients who would otherwise be deemed unsuitable for SVC stenting.
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom mkhalifa@nhs.net.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Khalifa
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Neeral
authors.initials: N
authors.lastname: Patel
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Steven
authors.initials: S
authors.lastname: Moser
mesh_terms: D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008875:Middle Aged; D010690:Phlebography; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D056824:Upper Extremity Deep Vein Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016306:Vena Cava Filters; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging
keywords: superior vena cava obstruction; superior vena cava stent; upper extremity deep vein thrombosis; vena cava filter