Abstract No. 636 A large-bore uncovered metallic stent for the treatment of malignant superior vena cava syndrome

Abstract

To investigate the safety and efficacy of large-bore uncovered metallic stent placement in patients with malignant superior vena cava (SVC) syndrome. Between August 2015 and December 2016, 27 consecutive patients (24 men and 3 women; mean age, 64.3 years; range, 52-80 years) with malignant SVC syndrome were retrospectively reviewed. All patients were treated with a large-bore uncovered metallic stent (20-30 mm in diameter). The size of stent was chosen based on the diameter of 15-25% larger than the SVC. The mean diameter of SVC and brachiocephalic vein (BCV) were 18.3 mm and 14 mm, respectively. Stent placement was technically successful in all 27 patients. The mean diameter of the stent was 24 mm. Any overstretching nor overdistension of SVC and BCV was not observed. There were no major complications. The pressure gradient, which was 18.9 ± 8.0 mm Hg before stent placement, dropped significantly to 4.3 ± 3.0 mm Hg after stent placement (p<0.001). Of the 25 patients symptomatic prior to stent placement, 23 (92%) experienced complete symptomatic relief 1-6 days after stent placement. The median patient survival and stent patency time were 116 days 116 days (95% confidence interval [CI], 80-150 days) and 116 days (95% CI, 77-155 days), respectively. Three (11%) of the 27 patients presented with stent dysfunction due to tumor ingrowth (n = 1) and intrastent thrombosis (n = 2). Large-bore uncovered metallic stent placement appeared to be a safe and effective method for treating malignant SVC syndrome.