Successful emergency stent implantation for superior vena cava perforation during malignant stenosis venoplasty

Iatrogenic injuries of the superior vena cava during endovascular treatments are a rare but life-threatening complication. According to the literature, treatment is mostly surgical. Herein we present the case of a patient undergoing venoplasty for a malignant superior vena cava syndrome. During balloon venoplasty the vessel wall perforated, leading to mediastinal as well as pericardial hemorrhage and cardiopulmonary shock. The lesion was effectively treated by an immediate reinflation of the venoplasty balloon followed by resuscitation and implantation of a covered stent. This procedure substantiates, first, the usefulness of interventional radiological methods for acute central venous hemorrhages and, second, the necessity to be adequately prepared for complications.