Thrombogenic superior vena cava syndrome from long-standing central venous access in a 5-year-old patient treated with balloon-expandable stents

J Radiol Case Rep. 2018 Apr 30;12(4):15-22. doi: 10.3941/jrcr.v12i4.3339. eCollection 2018 Apr.

Abstract

Thrombogenic superior vena cava syndrome is an uncommon, dangerous complication of long-standing central venous catheter use. The increased use of central venous catheters has resulted in more non-malignant cases of superior vena cava syndrome across all age groups. We present a 5-year-old male with superior vena cava syndrome associated with acute onset of severe upper extremity and facial swelling, dyspnea, and a right subclavian central venous catheter malfunction. The patient was ultimately treated with percutaneous stenting of the superior vena cava with balloon-expandable Palmaz stents following unsuccessful angioplasty, catheter-directed thrombolysis, and percutaneous thrombectomy. This case highlights a relatively uncommon complication in children from long-term central venous catheter access and describes an emerging, minimally-invasive therapeutic alternative that allows for preservation of age-appropriate superior vena cava luminal diameter as patients grow.

Keywords: balloon-expandable stents; long-standing central venous access; pediatric interventional radiology; percutaneous venous stenting; superior vena cava syndrome.

Publication types

  • Case Reports

MeSH terms

  • Angiography, Digital Subtraction
  • Catheterization, Central Venous / adverse effects*
  • Child, Preschool
  • Diagnosis, Differential
  • Humans
  • Male
  • Radiography, Interventional
  • Stents*
  • Superior Vena Cava Syndrome / diagnostic imaging*
  • Superior Vena Cava Syndrome / etiology*
  • Superior Vena Cava Syndrome / surgery*
  • Thrombectomy
  • Ultrasonography