EXPANDABLE WALLSTENT FOR THE TREATMENT OF OBSTRUCTION OF THE SUPERIORVENA-CAVA

Background-Palliative treatments for obstruction of the superior vena cava all have disadvantages. The use of a fine braided wire self expan ding stent (Wallstent, Schneider (Europe) AG) in patients with maligna nt and benign causes of superior vena cava obstruction is reported. Me thods-Five patients with obstruction of the superior vena cava were tr eated with balloon angioplasty of the stricture and the percutaneous i nsertion of an expandable Wallstent endoprosthesis across the site of the stricture. Four patients had advanced mediastinal malignancy previ ously treated by radiotherapy and one patient had fibrosing mediastini tis. Results-All patients experienced rapid symptomatic relief and, in three cases, complete palliation was achieved during survival times o f seven weeks, nine weeks, and 24 weeks, respectively. Two surviving p atients (with a recurrent thymoma and fibrosing mediastinitis) were fr ee of symptoms when followed up at eight and nine months respectively. Conclusions-Initial experience with the Wallstent endoprosthesis sugg ests that it is a valuable treatment alternative once conventional the rapy has failed and gives rapid relief of symptoms to patients with ob struction of the superior vena cava.