Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Endovascular treatment in patients with superior vena cava syndrome

Authors: Petrosyan K.V., Rakhmankulov I.Kh.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2020-17-4-299-307

UDC: 616.12-007.1-053.1-089.844

Link: Clinical Physiology of Blood Circulaiton. 2020; 4 (17): 299-307

Quote as: Petrosyan K.V., Rakhmankulov I.Kh. Endovascular treatment in patients with superior vena cava syndrome. Clinical Physiology of Circulation. 2020; 17 (4): 299–307 (in Russ.). DOI: 10.24022/1814-6910-2020-17-4-299-307

Received / Accepted:  30.06.2020 / 21.07.2020

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Abstract

Superior vena cava syndrome (SVCS) is a consequence of impaired circulation in the superior vena cava (SVC) system, which is the main blood outflow route from the head, neck and upper half of the body. The frequency of this syndrome reaches 0.005% in the total population annually and in most cases, the SVCS is a consequence of malignant neoplasms. Recently, the number of SVCS cases that are not related to cancer has significantly increased, which is primarily due to the active use of intravascular devices, such as central venous catheters and pacemakers and also increase of open-heart surgery volume. In the Russian Federation, an increase 2.05 times in the volume of endovascular treatment in the pathology of the systemic veins is observed from 22 to 45 procedures from 2015 to 2018. The range of endovascular technologies used for SVCS is expanding: transluminal balloon angioplasty and stenting, intravascular imaging, directional thrombolysis and thrombextraction, cutting balloons, cryotherapy in the area of obstruction and ultrahigh-pressure balloons. Against the background of extremely high immediate efficacy, the need arises for a thorough assessment of the long-term effectiveness of endovascular treatment and predictors of adverse outcomes in SVC obstruction. This article presents a literature review on endovascular treatment of SVC obstruction of various etiologies. The techniques, complications and results of endovascular treatment are described in detail, with more attention paid to the issues of stent implantation in this pathology.

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****
  1. Wilson L.D., Detterbeck F.C., Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes. N. Engl. J. Med. 2007; 18 (356): 1862–9. DOI: 10.1056/NEJMcp067190
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  30. Ploegmakers M.J.M., Rutten M.J.C.M. Fatal pericardial tamponade after superior vena cava stenting. Cardiovasc. Intervent. Radiol. 2009; 3 (32): 585–9. DOI: 10.1007/s00270-008-9443-0
  31. Taylor J.D., Lehmann E.D., Belli A.-M., Nicholson A.A., Kessel D., Robertson I.R. et al. Strategies for the management of SVC stent migration into the right atrium. Cardiovasc. Intervent. Radiol. 2007; 5 (30): 1003–9. DOI: 10.1007/s00270-007-9109-3 34. Srinathan S., McCafferty I., Wilson I. Radiological management of superior vena caval stent migration and infection. Cardiovasc. Intervent. Radiol. 2005; 1 (28): 127–30. DOI: 10.1007/s00270-003-0183-x
  32. Watkinson A.F., Yeow T.N., Fraser C. Endovascular stenting to treat obstruction of the superior vena cava. BMJ. 2008; 7658 (336): 1434–7. DOI: 10.1136/bmj. 39562.512789.80
  33. Rowell N.P., Gleeson F.V. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin. Oncol. (R. Coll. Radiol). 2002; 5 (14): 338–51. DOI: 10.1053/clon.2002.0095
  34. Tanigawa N., Sawada S., Mishima K., Okuda Y., Mizukawa K., Ohmura N. et al. Clinical outcome of stenting in superior vena cava syndrome associated with malignant tumors. Comparison with conventional treatment. Acta Radiol. 1998; 6 (39): 669–74. DOI: 10.3109/02841859809175494
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  36. De Gregorio Ariza M.A., Gamboa P., Gimeno M.J., Alfonso E., Mainar A., Medrano J. et al. Percutaneous treatment of superior vena cava syndrome using metallic stents. Eur. Radiol. 2003; 4 (13): 853–62. DOI: 10.1007/s00330-002-1489-9
  37. Sheikh M.A., Fernandez B.B.J., Gray B.H., Graham L.M., Carman T.L. Endovascular stenting of nonmalignant superior vena cava syndrome. Catheter. Cardiovasc. Interv. 2005; 3 (65): 405–11. DOI: 10.1002/ccd.20458
  38. Qanadli S.D., El Hajjam M., Mignon F., de Kerviler E., Rocha P., Barre O. et al. Subacute and chronic benign superior vena cava obstructions: endovascular treatment with self-expanding metallic stents. Am. J. Roentgenol. 1999; 1 (173): 159–64. DOI: 10.2214/ajr.173.1. 10397119
  39. Bornak A., Wicky S., Ris H.-B., Probst H., Milesi I., Corpataux J.-M. Endovascular treatment of stenoses in the superior vena cava syndrome caused by nontumoral lesions. Eur. Radiol. 2003; 5 (13): 950–6. DOI: 10.1007/s00330-002-1637-2
  40. Rizvi A.Z., Kalra M., Bjarnason H., Bower T.C., Schleck C., Gloviczki P. Benign superior vena cava syndrome: stenting is now the first line of treatment. J. Vasc. Surg. 2008; 2 (47): 372–80. DOI: 10.1016/j.jvs.2007.09.071

About Authors

  • Karen V. Petrosyan, Cand. Med. Sc., Head of Department of X-ray Surgical Methods of Research and Treatment of the Heart and Blood Vessels; ORCID
  • Islam Kh. Rakhmankulov, Postgraduate, Cardiologist; ORCID

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