Chest Port Placement Through a Recently Placed Superior Vena Cava Stent Using a Hemostatic Vascular Sheath: A Case...

A 57-year-old man with extensive-stage small cell lung cancer presented with superior vena cava (SVC) syndrome caused by a right upper lobe mass and underwent stenting from the SVC to the left brachiocephalic vein. Because ongoing chemotherapy required durable central venous access, chest port placement was subsequently attempted after stent placement. However, advancing a conventional peel-away sheath across the recently placed stent was considered undesirable because of the risk of stent deformation or displacement. A chest wall port was successfully placed by advancing only the guidewire and catheter through the stent interstices using an 8-Fr hemostatic vascular sheath instead of a peel-away sheath. Imaging confirmed appropriate catheter course and tip position within the stented segment. This case illustrates a feasible and practical alternative for central venous access following malignant SVC stenting.