A case of a bloated face: SVC syndrome relieved by an endovascular approach

Superior vena cava (SVC) syndrome, or obstruction of blood returning from the head and upper extremities, is a syndrome that is rapidly increasing in the cardiovascular patient population due to the increasing use of transvenous devices such as permanent pacemakers, implantable cardioverter defibrillators (ICDs), and indwelling venous access devices for hemodialysis. This syndrome in the past has been seen predominately in the cancer population with malignancy being the most common reason for SVC syndrome. The management of this syndrome has largely been with a medical/supportive care approach or with surgical bypass. Given the advancement in the field of endovascular interventions and the increasing expertise in performing these procedures, an endovascular approach to relieving the SVC obstruction is rapidly becoming the treatment of choice for these patients. We describe a case of a patient who had a chronic indwelling port-a-cath who developed SVC syndrome, which was treated with an endovascular approach with stenting of the SVC/brachiocephalic vein junction.