Anesthetic Implications of Superior Vena Cava Syndrome in Interventional Radiology: A Case Report

Superior vena cava syndrome is caused by obstruction of the thoracic vascular bed by either external compression or occlusion. Symptoms of this syndrome are associated with venous congestion: head and neck swelling, upper extremity edema, oropharyngeal and nasal edema, headaches and syncope caused by increasing intracranial pressure, orbital edema, cough, hoarseness, stridor, vocal cord edema, and vocal cord paralysis. This syndrome and its symptoms can pose an anesthetic challenge. Management of these patients arriving in the operating room (OR) for general anesthesia is well described in the literature. Anes-thetic management for treatment modalities in off-site procedure rooms outside the OR, however, is a fairly rare occurrence with great potential for adverse outcomes. This case report describes a case performed in the interventional radiology suite and the subsequent difficulties related to the anesthetic management of superior vena cava syndrome outside the safety and controlled environment of the OR.