Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause.
PurposeThe purpose of this paper is the retrospective analysis of endovascular therapy for the treatment of superior vena cava syndrome (SVCS) of malignant cause. This study focuses on the effectiveness of the therapy regarding the duration of remission, symptom control and practicability.Materials and MethodsFrom January 2003 to November 2012, therapeutic implantation of one or more stents was performed in 141 patients suffering from SVCS. The medical history was retrospectively researched using digitalized patient files. If those were incomplete, secondary research was conducted using the cancer registry of the General Hospital Nuremberg, the cancer registry of the tumor center at Friedrich-Alexander-University Erlangen-Nuremberg (FAU) or information given by physicians in private practice. This data was collected using Microsoft Office Excel®and statistically analyzed using IBM SPSS Statistics 22®.Results168 stents were implanted in 141 patients (median age: 64.6 years; range: 36 - 84), 86 being male and 55 being female. In 121 patients, SVCS was caused by lung cancer (85.8 %), in 9 patients by mediastinal metastasis of an extrathoracic carcinoma (6.4 %), in 3 patients by mesothelioma of the pleura (2.1 %) and in 1 patient by Hodgkin's disease (0.7 %). There was no histological diagnosis in 7 cases (4.9 %). The primary intervention was successful in 138 patients (97.9 %). Immediate thrombosis in the stent occurred in the remaining 3 cases. Recurrence of SVCS was observed in 22 patients (15.6 %), including 5 early and 17 late occlusions. Stent dislocation or breakage was not observed. As expected, the survival after implantation was poor. The median survival was 101 days, and the median occlusion-free survival was 80 days.ConclusionThe symptomatic therapy of SVCS with endovascular stents is effective and safe. Despite effective symptom control and a low rate of recurrence, the patients' prognosis is poor.Key Points:· Patients with SVCS of malignant cause have a poor prognosis.. · Lung cancer is the most common cause for SVCS.. · Endovascular therapy is safe and effective..Citation Format· Büstgens FA, Loose R, Ficker JH et al. Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause. Fortschr Röntgenstr 2017; 189: 423 - 430.
Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany.
Felix A
FA
Büstgens
Department of Radiology and Nuclear Medicine, Paracelsus Medical University Nuremberg, General Hospital Nuremberg, Germany.
Reinhard
R
Loose
Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University Nuremberg, General Hospital Nuremberg, Germany.
Joachim H
JH
Ficker
Institute of Medical Physics, General Hospital Nuremberg, Germany.
Michael
M
Wucherer
Department of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany.
Michael
M
Uder
Department of Radiology and Nuclear Medicine, Paracelsus Medical University Nuremberg, General Hospital Nuremberg, Germany.
Ralf
R
Adamus
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D015897:Comorbidity; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy; D015995:Prevalence; D019919:Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000401:mortality*; D015996:Survival Rate; D016896:Treatment Outcome