Endovascular treatment of malignant superior vena cava syndrome secondary to lung cancer

Hosp Pract (1995). 2017 Aug;45(3):70-75. doi: 10.1080/21548331.2017.1342507. Epub 2017 Jun 26.

Abstract

Objectives: Superior Vena Cava obstruction results in severe oedema of the upper thorax. Endovascular treatment allows a rapid restoration of the blood flow with a rapid resolution of symptoms. We retrospectively report a single institution's experience in stent placement for malignant Superior Vena Cava Syndrome (SVCS) caused by lung cancer.

Methods: Thirty-three consecutive patients (23 men, 10 women; median age, 57.6 years; range 34-71 years) who underwent endovascular SVCS palliative treatment were enrolled between August 2002 and June 2015. All patients presented SVCS secondary to lung cancer. Signs and symptoms of SVCS were scored.

Results: All procedures were successfully completed (100% technical success rate). Twenty-eight patients showed a progressive clinical improvement after endovascular treatment of SVCS (84.8% clinical success rate) within 48 hours, there were five clinical failures which improved progressively with posterior radiotherapy. During follow-up, three patients (9%) suffered intra or post-procedural complications (1 cardiac arrhythmia, 2 stent thrombosis).

Conclusions: Stent placement in malignant SVCS seems to be an effective and rapid treatment for the relief of symptoms and quality of life improvement with a relatively low complications rate with a rapid resolution of symptoms. Therefore, it should be seriously considered as the first option in the SVC obstruction treatment.

Keywords: Stent; endovascular procedure; lung cancer; superior vena cava syndrome.

MeSH terms

  • Adult
  • Aged
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Intraoperative Complications / epidemiology
  • Lung Neoplasms / complications*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Quality of Life
  • Retrospective Studies
  • Severity of Illness Index
  • Stents*
  • Superior Vena Cava Syndrome / etiology*
  • Superior Vena Cava Syndrome / surgery*