Single center experience with percutaneous endovascular repair of superior vena cava syndrome

Abstract

Objectives: To demonstrate short-term effectiveness and long-term efficacy of percutaneous transluminal angioplasty (PTA) with or without adjunctive therapy in treatment of superior vena cava syndrome (SVCS). Background: Recently, PTA with or without adjunctive therapy has evolved as first-line therapy for SVCS. Despite growing evidence for PTA with or without adjunctive therapy, there are little data reflecting its short- and long-term outcomes. Methods: We retrospectively reviewed 14 consecutive patients undergoing PTA with or without adjunctive therapy for SVCS, between July 2001 and September 2009. Results: A total of 14 patients (nine women; mean age, 49 ± 15 years) with SVCS underwent attempted PTA with or without adjunctive therapy. Causes of SVCS were indwelling catheters or pacemaker wires (n = 5), idiopathic (n = 5), thoracic outlet syndrome (n = 2), and cancer-related thrombosis (n = 2). Obstruction of the SVC involved inflow branches in 86% of patients (n = 12). PTA with or without adjunctive therapy was attempted in all 14 patients and was angiographically successful in 93% (n = 13). PTA and stenting was performed in eight (57%) patients; three (21%) patients had PTA with thrombectomy/ thrombolysis; one (7%) patient had PTA alone; and one (7%) patient had thrombectomy/thrombolysis alone. Symptom relief was seen in 86% (n = 12), and initial patency was 90%. There were no procedural complications. Mean follow-up was 12 months, and no deaths were reported. In the 11 (79%) patients with follow-up imaging, nine (82%) patients showed patency and two (18%) had residual symptoms, with one patient undergoing surgery. Conclusions: PTA with adjunctive endovascular stent therapy for SVCS is safe and effective at giving both rapid and sustained symptom relief. © 2011 Wiley-Liss, Inc.