RADIOLOGICAL INTERVENTIONS IN CENTRAL VENOUS OBSTRUCTIONS - DILATATION, STENT-IMPLANTATION AND THROMBOLYSIS

Purpose: Venous congestion of the superior or inferior caval system ha s to be considered as a medical emergency. The results of various reca nalization procedures and their utility are analyzed. Patients and met hods: 176 patients with superior and 28 with inferior caval obstructio n were treated with Gianturco-Z (n=39) and Wall Stents (n=207) respect ively. Balloon venoplasty was performed prior to stent implantation. I n 27 cases,local thrombolysis with urokinase was employed. Results: In terventional procedures were succesful in 198 and without success in 6 patients. In most patients, symptoms were relieved during or early af ter recanalization. No major complications were found. Discussion: Bal loon angioplasty with stent placement and local thrombolysis are succe ssful in the treatment of superior and inferior caval obstruction. Sel f-expanding Wallstents are superior to Gianturco-Z-stents. Oncologists should be made familiar with this type of treatment.