The Patency Rate of Endovascular Procedure in Patients with Superior Vena Cava Syndrome Caused by Intravenous Catheterization: A Case Series and Longitudinal Study
Abstract
Introduction: Different methods have been well addressed in literature in terms of treating superior vena cava (SVC) syndrome; nevertheless, the patency of endovascular treatment has rarely been investigated in patients with SVC syndrome in patients with central venous access. Objectives: The present study was performed to assess the patency rate of endovascular procedure in patients with SVC syndrome caused by intravenous catheterization. Methods: The present case series and longitudinal study was conducted on patients with SVC syndrome in presence of central venous catheter who underwent venoplasty. Computed tomography (CT) venography was performed 1, 6 and 12 months after venoplasty. Facial swelling, facial discomfort, extremity edema, arteriovenous fistula (AVF) dysfunction, impairment in dialysis and SVC stenosis were measured at baseline and 1, 6 and 12 months after venoplasty. Results: Out of 20 investigated patients, 11 (55%) were male. Significantly decreases were observed in the median grades of facial swelling and extremity edema in the follow-up (P<0.001). The decrease in facial discomfort was statistically insignificant (P=0.129), and the median grade of SVC stenosis significantly decreased from 1.5 to zero in the follow-up (P<0.001). A statistically-significant decrease was observed in AVF dysfunction (P=0.007), and impairment in dialysis significantly decreased after the intervention during the follow-up (P<0.001). Conclusion: Findings of the present study revealed the appropriate patency rate of endovascular treatment in patients with SVC syndrome in presence of central venous catheter.
2. Hinton J, Cerra-Franco A, Shiue K, Shea L, Aaron V, Billows G, et al. Superior vena cava syndrome in a patient with locally advanced lung cancer with good response to definitive chemoradiation: a case report. J Med Case Rep. 2018;12:301.
3. Wehbe MR, Hoballah JJ. Superior Vena Cava Syndrome. InCurrent Management of Venous Diseases 2018 (pp. 547-556). Springer, Cham.
4. Kim DH, Jeon YS, Kim GC, Ahn IS, Kwan J, Park KS, et al. Superior vena cava syndrome caused by encircling soft tissue. Korean J Intern Med. 2007;22(2):118-21.
5. Ji D, Gill AE, Ermentrout RM, Hawkins CM. Thrombogenic superior vena cava syndrome from long-standing central venous access in a 5-year-old patient treated with balloon-expandable stents. J Radiol Case Rep. 2018;12(4):15-22.
6. Kalra M, Gloviczki P, Andrews JC, Cherry Jr KJ, Bower TC, Panneton JM, et al. Open surgical and endovascular treatment of superior vena cava syndrome caused by nonmalignant disease. J Vasc Surg. 2003;38(2):215-23.
7. De Raet JM, Vos JA, Morshuis WJ, van Boven WJ. Surgical management of superior vena cava syndrome after failed endovascular stenting. Interact Cardiovasc Thorac Surg. 2012; 15(5):915-7.
8. Brodovicz KG, McNaughton K, Uemura N, Meininger G, Girman CJ, Yale SH. Reliability and feasibility of methods to quantitatively assess peripheral edema. Clin Med Res. 2009;7(1-2):21-31.
9. Kim YI, Kim KS, Ko YC, Park CM, Lim SC, Kim YC, et al. Endovascular stenting as a first choice for the palliation of superior vena cava syndrome. J Korean Med Sci. 2004;19(4):519-22.
10. Zimmerman S, Davis M. Rapid fire: superior vena cava syndrome. Emerg Med Clin North Am. 2018;36(3):577-84.
11. Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore). 2006;85(1):37-42.
12. Urruticoechea A, Mesıa R, Domınguez J, Falo C, Escalante E, Montes A, et al. Treatment of malignant superior vena cava syndrome by endovascular stent insertion: experience on 52 patients with lung cancer. Lung Cancer. 2004;43(2):209-14.
13. Kee ST, Kinoshita L, Razavi MK, Nyman UR, Semba CP, Dake MD. Superior vena cava syndrome: treatment with catheter-directed thrombolysis and endovascular stent placement. Radiology. 1998;206(1):187-93.
14. Lanciego C, Chacon JL, Julian A, Andrade J, Lopez L, Martinez B, et al. Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. AJR Am J Roentgenol. 2001;177(3):585-93.
15. Kalra M, Gloviczki P, Andrews JC, Cherry Jr KJ, Bower TC, Panneton JM, et al. Open surgical and endovascular treatment of superior vena cava syndrome caused by nonmalignant disease. J Vasc Surg. 2003;38(2):215-23.
16. Dinkel HP, Mettke B, Schmid F, Baumgartner I, Triller J, Do DD. Endovascular treatment of malignant superior vena cava syndrome: is bilateral wallstent placement superior to unilateral placement? J Endovasc Ther. 2003;10(4):788-97.
17. Bierdrager E, Lampmann LE, Lohle PN, Schoemaker CM, Schijen JH, Palmen FM, et al. Endovascular stenting in neoplastic superior vena cava syndrome prior to chemotherapy or radiotherapy. Neth J Med. 2005;63(1):20-3.
18. Hooker JB, Hawkins BM, Abu-Fadel MS. Endovascular Stenting in 2 Patients with Benign Superior Vena Cava Syndrome. Tex Heart Inst J. 2018;45(4):264-9.
19. Shatila W, Almanfi A, Massumi M, Dougherty KG, Parekh DR, Strickman NE. Endovascular treatment of superior vena cava syndrome via balloon-in-balloon catheter technique with a palmaz stent. Tex Heart Inst J. 2016;43(6):520-3.
20. Nicholson AA, Ettles DF, Arnold A, Greenstone M, Dyet JF. Treatment of malignant superior vena cava obstruction: metal stents or radiation therapy. J Vasc Interv Radiol. 1997;8(5):781-8.
21. Oderich GS, Treiman GS, Schneider P, Bhirangi K. Stent placement for treatment of central and peripheral venous obstruction: a long-term multi-institutional experience. J Vasc Surg. 2000;32(4):760-9.
22. Brodovicz KG, McNaughton K, Uemura N, Meininger G, Girman CJ, Yale SH.Reliability and feasibility of methods to quantitatively assess peripheral edema. Clin Med Res. 2009;7(1-2):21-31
23. Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15(1):S17-24.
24. Zamboli P, Fiorini F, D’Amelio A, Fatuzzo P, Granata A. Color Doppler ultrasound and arteriovenous fistulas for hemodialysis. J Ultrasound. 2014;17(4):253-63.
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Issue | Vol 4 No 3 (2020): Summer (July) | |
Section | Original article | |
Keywords | ||
Catheterization, Central Venous Endovascular Procedures Superior Vena Cava Syndrome |
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