Superior vena cava syndrome: endovascular management
Superior vena cava syndrome: endovascular management
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DOI：
10.1590/1677-5449.180062
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Belczak, Sergio Quilici
中科院分区：
文献类型：
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作者：
Karakhanian, Walter Kegham;Karakhanian, Walter Zavem;Belczak, Sergio Quilici
背景：上级腔静脉综合征（SVCS）的治疗目的是及时缓解不适症状。传统的方法并不总是能达到效果迅速血管内管理与stent placement. Adjectives：报告的经验与血管内管理SVCS的血管和血管内手术服务在巴西大学hospital.METHODS：症状III型SVCS的情况下，血管成形术和支架置入术在28例患者年龄从37岁到68岁，2002年和2012年之间。SVCS的病因是肺癌或胸部肿瘤的18例，而阻塞的静脉长期使用导管的原因是在其他cases.Results：上级腔静脉闭塞修复是不可能的一个非常严重的病变的症状少的患者。技术成功率为96.4%。有两例死亡，一例是由于肺栓塞，手术成功后24小时，另一例是由于手术后几小时肿瘤块压迫气道。所有技术成功病例均获得临床成功，包括1例SVCS症状完全消退后突然死亡的患者。症状消失后24小时和48小时分别在16和8例患者的管理;改善较慢，但在48小时后进行性在其余patients.CONCLUSIONS：血管内支架置入术是有效的SVCS管理，具有良好的技术和临床成功率，并提供及时缓解症状。
BACKGROUND: The objective of management of superior vena cava syndrome (SVCS) is to promptly alleviate the uncomfortable symptoms. Conventional approaches do not always achieve results as rapidly as endovascular management with stent placement.OBJECTIVES: To report the experience with endovascular management of SVCS of a Vascular and Endovascular Surgery Service at a Brazilian university hospital.METHODS: Symptomatic type III SVCS cases were managed with angioplasty and stent placement in 28 patients aged from 37 to 68 years, between 2002 and 2012. The etiology of SVCS was lung or thoracic cancer in 18 patients, while occlusion of the vein for prolonged use of catheters was the cause in the other 10 cases.RESULTS: Superior vena cava occlusion repair was not possible in one oligosymptomatic patient with a very severe lesion. Technical success was achieved in 96.4%. There were two deaths, one due to pulmonary embolism, 24 hours after a successful procedure, and the other due to compression of the airways by tumor mass some hours after the procedure. Clinical success was achieved in all cases of technical success, including one patient who died suddenly, after total regression of SVCS symptoms. Symptoms disappeared 24 hours and 48 hours after management in16 and 8 patients respectively; improvement was slower but progressive after 48 hours in the remaining patients.CONCLUSIONS: Endovascular stent placement was effective for management of SVCS, with good technical and clinical success rates and provided prompt relief from symptoms.