Single center experience with percutaneous endovascular repair of superior vena cava syndrome

To demonstrate short-term effectiveness and long-term efficacy of percutaneous transluminal angioplasty (PTA) with or without adjunctive therapy in treatment of superior vena cava syndrome (SVCS).

Recently, PTA with or without adjunctive therapy has evolved as first-line therapy for SVCS. Despite growing evidence for PTA with or without adjunctive therapy, there are little data reflecting its short- and long-term outcomes.

We retrospectively reviewed 14 consecutive patients undergoing PTA with or without adjunctive therapy for SVCS, between July 2001 and September 2009.

A total of 14 patients (nine women; mean age, 49 ± 15 years) with SVCS underwent attempted PTA with or without adjunctive therapy. Causes of SVCS were indwelling catheters or pacemaker wires (n = 5), idiopathic (n = 5), thoracic outlet syndrome (n = 2), and cancer-related thrombosis (n = 2). Obstruction of the SVC involved inflow branches in 86% of patients (n = 12). PTA with or without adjunctive therapy was attempted in all 14 patients and was angiographically successful in 93% (n = 13). PTA and stenting was performed in eight (57%) patients; three (21%) patients had PTA with thrombectomy/thrombolysis; one (7%) patient had PTA alone; and one (7%) patient had thrombectomy/thrombolysis alone. Symptom relief was seen in 86% (n = 12), and initial patency was 90%. There were no procedural complications. Mean follow-up was 12 months, and no deaths were reported. In the 11 (79%) patients with follow-up imaging, nine (82%) patients showed patency and two (18%) had residual symptoms, with one patient undergoing surgery.

PTA with adjunctive endovascular stent therapy for SVCS is safe and effective at giving both rapid and sustained symptom relief.