Treatment of malignant superior vena cava syndrome by endovascular stent insertion: Experience on 52 patients with lung cancer

Background: Superior vena cava syndrome (SVCS) is a frequent presentation of malignancies involving the mediastinum and can seriously compromise treatment options and prognosis. Stenting of superior vena cava is a well-known but not so commonly used technique to alleviate this syndrome. Patients and...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Vol. 43; no. 2; pp. 209 - 214
Main Authors: Urruticoechea, A., Mesı́a, R., Domı́nguez, J., Falo, C., Escalante, E., Montes, A., Sancho, C., Cardenal, F., Majem, M., Germà, J.R.
Format: Journal Article
Language:English
Published: Shannon Elsevier Ireland Ltd 01.02.2004
Elsevier Science
Subjects:
Adult
Aged
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Disease Progression
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Hemorrhage - etiology
Humans
Lung cancer
Lung Neoplasms - complications
Male
Mediastinum malignances
Medical sciences
Middle Aged
Non-small cell lung cancer
Prognosis
Small cell lung cancer
Stent
Stents
Superior vena cava syndrome
Superior Vena Cava Syndrome - etiology
Superior Vena Cava Syndrome - pathology
Superior Vena Cava Syndrome - surgery
Treatment Outcome
Vascular Surgical Procedures - instrumentation
Vascular Surgical Procedures - methods
Vena cava obstruction
Small cell lung cancer
Lung cancer
Non-small cell lung cancer
Superior vena cava syndrome
Mediastinum malignances
Stent
Vena cava obstruction
Human
Lung disease
Endoprosthesis
Respiratory disease
Insertion
Instrumentation therapy
Cardiovascular disease
Malignant tumor
Bronchopulmonary malignant tumor
Vascular disease
Vena cava disease
Bronchus disease
Superior vena cava
ISSN:0169-5002, 1872-8332
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Summary:Background: Superior vena cava syndrome (SVCS) is a frequent presentation of malignancies involving the mediastinum and can seriously compromise treatment options and prognosis. Stenting of superior vena cava is a well-known but not so commonly used technique to alleviate this syndrome. Patients and methods: Between August 1993 and December 2000 we performed 52 stenting procedures in patients affected by non-small cell lung cancer (NSCLC). Results: Phlebographic resolution of the obstruction was achieved in 100% of cases with symptomatic and subjective improvement in more than 80%. One major complication was observed due to bleeding during anticoagulation. Re-obstruction of the stent occurred in only 17% of the cases, the majority due to disease progression. Improvement of the syndrome allowed hydration necessary for full dose platinum treatment when indicated in patients affected by lung cancer. Conclusions: Stenting of the superior vena cava syndrome is a safe and effective procedure achieving a rapid alleviation of symptoms in almost all patients, and allowing for full dose treatment in lung cancer patients. This procedure could change the traditional poorer prognosis attributed to non-small cell lung cancer patients presenting with this syndrome.
Bibliography:ObjectType-Article-2
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ISSN:0169-5002
1872-8332
DOI:10.1016/S0169-5002(03)00361-1