Treatment of superior and inferior vena cava syndromes of malignant cause with Wallstent catheter placed percutaneously

Am J Clin Oncol. 1997 Jun;20(3):293-7. doi: 10.1097/00000421-199706000-00018.

Abstract

Superior vena cava syndrome (SVCS) and inferior vena cava syndrome (IVCS) represent a severe symptomatic complication of some malignant tumors. Although radiation therapy and chemotherapy are elective, symptomatic relief takes 7-10 days to be achieved, and poor symptomatic benefit can be obtained in relapsed or resistant tumors. We report on a palliative approach using Wallstent catheters placed percutaneously in a series of 16 patients. Results obtained in relief of symptoms were excellent (complete response of cephalea, jugular enlargement, and collateral circulation achieved in 100% [16/16] of patients; complete response of edema obtained in 93% [15/16] of patients). Achievement of symptomatic response was obtained for all symptoms during the first 24 h poststenting, except for edema and dyspnea. Mean duration of patency of the stents was 6.4 months (range 2-17 months). Rates of morbidity and complications were very low. Dyspnea was a quite resistant symptom, and only four of 13 patients (31%) obtained complete response, while partial improvement was obtained in the other nine (79%). However, placement of the stents does not preclude the use of radiation therapy or chemotherapy. We think that these results and those from other studies warrant larger multicentric trials.

MeSH terms

  • Aged
  • Blood Vessel Prosthesis*
  • Combined Modality Therapy
  • Constriction, Pathologic
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Stents*
  • Superior Vena Cava Syndrome / etiology*
  • Superior Vena Cava Syndrome / therapy*
  • Survival Analysis
  • Thoracic Neoplasms / complications*
  • Time Factors
  • Vascular Patency
  • Vena Cava, Inferior*