Abstract
ObjectivesTo evaluate the efficacy of percutaneous stent placement in the treatment of superior vena cava syndrome caused by malignant tumors.MethodsWe retrospectively analyzed the clinical data of 32 patients with superior vena cava syndrome who underwent percutaneous endovascular stent treatment in our department from 2015 to 2019 due to malignant tumors and summarized the patient’s sex, age, tumor type, endovascular treatment plan, complications and postoperative follow-up.ResultsAll patients successfully underwent percutaneous intraluminal stent placement with digital subtraction angiography (DSA). Thirty-seven endovascular stents were implanted in 32 patients, including 21 Eluminexx stents, 12 Wallstent stents and 4 covered stents. The technical success rate was 100%, and there were no serious surgery-related complications. The remission rate of clinical symptoms was 53.1% (17/32) at 24 h and 84.4% (27/32) at 48 h. After 48 h, the symptoms of the remaining patients were slowly relieved, and the symptom relief rate was 100% at 7 days. The follow-up period was 1.5–24 months, with an average follow-up period of 6.5 months. During the follow-up, 3 patients had restenosis and 1 patient had secondary thrombosis in the stent. Their symptoms were relieved after the second treatment.ConclusionFor superior vena cava syndrome caused by malignant tumors, percutaneous endoluminal stent therapy can quickly and effectively relieve the clinical symptoms of patients, and the incidence of complications is low.
Highlights
Superior vena cava syndrome (SVCS) can be secondary to exogenous compression, central venous catheter thrombosis, upper limb arteriovenous fistula, infectionSVCS caused by malignant tumors mainly actively treats the primary disease and restores the blood flow ofLiu et al Journal of Cardiothoracic Surgery (2021) 16:39 the superior vena cava as soon as possible to relieve clinical symptoms
Two stents were implanted in 5 patients, 2 of which were covered stents combined with bare metal stents, while the other 2 patients were treated with the stent drilling mesh technique, called the “Y” release, taking into account the superior vena cava and brachiocephalic vein (Fig. 2)
Medical radiotherapy and chemotherapy are still the main treatment options for patients with tumors combined with superior vena cava syndrome because they can treat the primary tumor, reduce the lesion area and reduce the compression of the superior vena cava, thereby alleviating the patient’s clinical symptoms
Summary
Superior vena cava syndrome (SVCS) can be secondary to exogenous compression, central venous catheter thrombosis, upper limb arteriovenous fistula, infectionSVCS caused by malignant tumors mainly actively treats the primary disease and restores the blood flow ofLiu et al Journal of Cardiothoracic Surgery (2021) 16:39 the superior vena cava as soon as possible to relieve clinical symptoms. Superior vena cava syndrome (SVCS) can be secondary to exogenous compression, central venous catheter thrombosis, upper limb arteriovenous fistula, infection. It was thought that tumor compression was the main cause of superior vena cava syndrome caused by tumors. Hinton et al reported a case of a non-small cell lung cancer patient, who received chemotherapy, and the tumor was reduced by more than 50%, but the superior vena cava stenosis was not relieved [7]. Lanciego recommends Wallstent endoprosthesis as the first choice for palliative treatment of superior vena cava syndrome [8]. We retrospectively analyzed the case data of patients with malignant superior vena cava obstruction who underwent stent placement in our hospital to verify its effectiveness, safety and efficacy
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