Iatrogenic superior vena caval syndrome

The superior vena caval (SVC) syndrome is a common oncological emergency requiring the quick initiation of appropriate therapy. However, it may also result from a medical procedure e.g. central catheter or temporary pacing wire insertion, with symptoms usually developing acutely and dramatically. If symptoms persist despite removal of the offending device, chemotherapy and radiotherapy are obviously precluded. Alternative treatment modalities include thrombolysis, thrombectomy devices, stents, and surgery. Clinically covert thrombosis is not uncommon, and as interventions and invasive procedures requiring central venous cannulations become commonplace, this iatrogenic complications will inevitably occur more often. Even the use of ultrasound guided insertion does not avoid catheter related obstruction. A case of an iatrogenc haemodialysis catheter related SVCS is presented and the aetiopathogensis, signs and symptoms, diagnosis, and management are discussed.