SUPERIOR VENA-CAVA SYNDROME - TREATMENT WITH CATHETER-DIRECTED THROMBOLYSIS AND ENDOVASCULAR STENT PLACEMENT

PURPOSE: To evaluate use of catheter-directed thrombolysis and/or endo vascular stent placement to treat superior vena cava (SVC) syndrome. M ATERIALS AND METHODS: Fifty-nine consecutive patients with SVC syndrom e were studied. The cause was underlying malignancy in 43 and benign d isease included in 31 cases and stenosed in 28. Twenty-seven patients underwent catheter-directed thrombolysis; 51 underwent endovascular st ent placement. Patency was defined in terms of absence of symptoms and signs of SVC syndrome. RESULTS: Technical success was achieved in 56 of 59 patients (95%). Among 42 patients with underlying malignancy (me an follow-up, 7.0 months; range, 1-34 months), primary clinical patenc y was achieved in 33 (79%) and secondary clinical patency was achieved in 39 (93%). Among 13 patients with benign disease (mean follow-up, 1 7.0 months; range, 1-27 months), primary clinical patency was achieved in 10 (77%) and secondary clinical patency was achieved in 11 (85%). Four patients were lost to follow-up. Periprocedural mortality and mor bidity rates were 3% (two of 59 patients) and 10% (six of 59 patients) , respectively. CONCLUSION: Catheter-directed thrombolysis and endovas cular stent placement is a safe and effective treatment of SVC syndrom e.