Percutaneous stenting of supyerior vena cava syndrome: Treatment outcome in patients with benign and malignant etiology
Percutaneous stenting of supyerior vena cava syndrome: Treatment outcome in patients with benign and malignant etiology
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DOI：
10.2310/6670.2007.00067
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发表时间：
2007-09-01
期刊：
影响因子：
1.1
通讯作者：
Lin, Peter H.
中科院分区：
文献类型：
--
作者：
Barshes, Neal R.;Annambhotla, Suman;Lin, Peter H.
有症状的上腔静脉阻塞(SVC)可由胸腔内恶性肿瘤或非恶性病因引起，导致上腔静脉综合征(SVCS)。本研究的目的是评价经皮血管内支架置入术治疗恶性和良性疾病的临床效果。在9年期间，56名上腔静脉综合征患者接受了经皮支架置入术。其中恶性病变40例(71%)，良性病变16例(29%)。Wallstent是最常用的支架，45例(80%)使用了Wallstent，6例(11%)使用了Palmaz支架。在38名患者(68%)中，使用单一支架治疗上腔静脉病变。相比之下，9例(16%)患者放置了双侧吻合性支架，这些支架从双侧头臂静脉延伸至上腔静脉近端。所有患者都取得了技术上的成功，而54名患者(96%)的症状有所改善。本组无手术并发症发生。1年后恶性组和良性组的原发通畅率分别为%和76%。总的无症状生存期为1~34个月。我们的研究表明，经皮支架血管内治疗为恶性或良性疾病引起的上腔静脉综合征患者提供了一种有效的治疗策略。
Symptomatic obstruction of the superior vena cava (SVC) can be caused by either intrathoracic malignancy or nonmalignant etiology resulting in superior vena cava syndrome (SVCS). The objective of this study was to evaluate the clinical outcome of percutaneous stenting of SVCS in patients with malignant and benign disease. During a 9-year period, 56 patients with SVCS underwent percutaneous stenting placement. Among them, malignant and benign disease was responsible for 40 patients (71%) and 16 patients (29%), respectively. The Wallstent was the most commonly used stent and was used in 45 patients (80%), whereas the Palmaz stent was used in 6 patients (11%). In 38 patients (68%), a single stent was deployed to treat an SVC lesion. In contrast, bilateral kissing stents were deployed in 9 patients (16%), which extended from bilateral brachiocephalic veins to the proximal SVC. Technical success was achieved in all patients while symptomatic improvement was noted in 54 patients (96%). No procedural complications occurred in this series. Primary patency in malignant and benign cases at 1 year was 64% and 76%, respectively. Overall symptom-free survival ranged from 1 to 34 months. Our study showed that endovascular treatment with percutaneous stenting provides an effective treatment strategy in patients with SVCS caused by either malignant or benign disease.