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[Superior vena cava syndrome].

F Stagnitti1, M Mongardini, M Coletti

  • 1Università degli Studi La Sapienza, Roma Istituto di Clinica Chirurgica d'Urgenza e di Pronto Soccorso.

Il Giornale Di Chirurgia
|February 5, 2003
PubMed
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Spontaneous superior vena cava thrombosis in cancer patients was treated with thrombolysis and stenting. This approach successfully recanalized the vein, resolving clinical symptoms and offering a viable option for high-risk individuals.

Area of Science:

  • Interventional Cardiology
  • Oncology
  • Vascular Surgery

Background:

  • Superior vena cava syndrome (SVCS) results from caval obstruction, presenting with respiratory symptoms and venous stasis.
  • Spontaneous superior vena cava thrombosis is a rare complication, particularly in cancer patients undergoing chemotherapy.

Purpose of the Study:

  • To evaluate the efficacy of locoregional thrombolysis followed by caval wall-stent placement for spontaneous superior vena cava thrombosis in neoplastic patients.

Main Methods:

  • Three female patients with spontaneous SVCS secondary to breast, uterine, and rectal cancer underwent treatment.
  • Locoregional thrombolysis using Urokinase was administered, followed by the placement of a 16/9 wallstent in the superior vena cava or subclavian-anonyma truncus.

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Main Results:

  • Complete stent opening within 48 hours was achieved in all cases without complications.
  • Successful recanalization resulted in a caval diameter of approximately 2 cm, leading to the resolution of clinical signs.

Conclusions:

  • Caval wall-stent placement is a primary and effective treatment for vein recanalization in patients with spontaneous superior vena cava thrombosis, especially those at high surgical risk.