A review of endovascular stenting for superior vena cava syndrome in fibrosing mediastinitis

Vasc Med. 2020 Apr;25(2):174-183. doi: 10.1177/1358863X19884130. Epub 2019 Dec 5.

Abstract

Fibrosing mediastinitis (FM) is a rare disorder of inflammation and fibrosis involving the mediastinum. The formation of fibroinflammatory mass in the mediastinum can lead to obstruction of mediastinal structures and cause severe debilitating and life-threatening symptoms. Superior vena cava syndrome (SVCS) is a dreaded complication of FM with no medical therapy proven to be efficacious. Spiral vein grafting has long been utilized as first-line therapy for SVC syndrome due to FM. Endovascular repair with stents and angioplasty for malignant causes of SVC syndrome is well established. However, there are limited data on their utility in SVC syndrome due to FM. We present two cases of SVC syndrome due to FM treated with endovascular stenting and a detailed review of current literature on its utility in SVCS due to benign causes.

Keywords: chronic venous disease; endovascular stent; fibrosing mediastinitis; superior vena cava syndrome; vascular complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Mediastinitis / complications*
  • Mediastinitis / diagnosis
  • Middle Aged
  • Sclerosis / complications*
  • Sclerosis / diagnosis
  • Stents*
  • Superior Vena Cava Syndrome / diagnostic imaging
  • Superior Vena Cava Syndrome / etiology
  • Superior Vena Cava Syndrome / physiopathology
  • Superior Vena Cava Syndrome / therapy*
  • Treatment Outcome
  • Vena Cava, Superior / diagnostic imaging
  • Vena Cava, Superior / physiopathology*

Supplementary concepts

  • Mediastinal Fibrosis