Outcome of stenting in central venous obstruction of benign etiology

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 45-51
Author(s):  
Houman Jalaie ◽  
Alexander Gombert ◽  
Jochen Grommes ◽  
Karina Schleimer ◽  
Ralph L. M. Kurstjens ◽  
...  
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Significant Risk ◽  
Central Vein ◽  
Secondary Patency ◽  
Venous Obstruction ◽  
Central Venous ◽  
Long Term Outcome ◽  
Venous Stenting ◽  
Central Venous Obstruction

Summary: Background: The aim of this study is to evaluate long term outcome in patients treated for benign superior vena cava (SVC) syndrome by endovascular techniques. Patients and methods: Between 2015 and 2018, 62 patients suffering from central venous obstruction of benign etiology underwent balloon angioplasty with stent placement for venous obstruction in our department. Patency was assessed clinically, using duplex ultrasound in all patients or with CT-phlebography in selected cases. Results: Median age was 60 years (23–83), forty-one patients (66%) had central venous devices. Swelling of the arm and face were the main symptoms (71%). During the median follow up of 22 months (9–38), cumulative primary patency was 71% after venous stenting. The cumulative assisted primary and the secondary patency were 85% and 92%, respectively. Conclusions: Recanalization and stenting of central vein obstruction has turned out to be the technique of reference and provides satisfactory mid-term patency rates. After adjusting for the risk factors, presence of AV-fistula remained a significant risk factor for recurrent stenosis or loss of patency after intervention.

scholarly journals Stent Implantation for Effective Treatment of Refractory Chylothorax due to Superior Vena Cava Obstruction as a Complication of Congenital Cardiac Surgery

2012 ◽  
Vol 6 ◽  
pp. CMC.S8687 ◽  
Author(s):  
Akiko Tamai ◽  
Clara Kurishima ◽  
Mitsuru Seki ◽  
Satoshi Masutani ◽  
Mio Taketazu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Superior Vena Cava ◽  
Stent Implantation ◽  
Conservative Therapy ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Obstruction ◽  
Central Venous ◽  
Congenital Cardiac Surgery ◽  
Central Venous Obstruction

Chylothorax is a serious complication of congenital cardiac surgery and is significantly associated with increased morbidity and mortality. Central venous obstruction, which is often related to the insertion of central venous catheters for postoperative management, is known to be an important risk factor for treatment failure and mortality associated with this condition. We present the case of a 6-month-old girl with refractory chylothorax after surgical repair of tetralogy of Fallot. The chylous drainage continued for more than 2 months despite maximal conservative therapy (water restriction, total parenteral nutrition, and infusion of somatostatin and steroid) and surgical ligation of the thoracic duct. Subsequently, we observed stenosis of the superior vena cava (SVC) caused by large thrombi possibly associated with the prolonged use of central venous catheter placed in the internal jugular vein. Because transcatheter balloon dilation failed to relieve the stenosis, we performed stent implantation for the SVC and innominate vein. After the procedure, chylous drainage dramatically reduced, and the patient was discharged from the hospital. In conclusion, central venous obstruction due to thrombosis should be routinely examined when chylothorax is diagnosed and is resistant to conservative therapy after congenital heart surgery. Stent implantation can effectively relieve the venous obstruction and thus be a life-saving treatment option for this difficult condition.

scholarly journals Tunnelled central venous catheter–induced thrombosis: a rare case of superior vena cava syndrome

CJEM ◽  
2005 ◽  
Vol 7 (04) ◽  
pp. 273-277 ◽  
Author(s):  
Sandeep K. Aggarwal ◽  
William McCauley
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Obstruction ◽  
Central Venous ◽  
Arm Swelling ◽  
Vena Cava Syndrome

ABSTRACTThrombotic venous obstruction in patients with a tunnelled central venous catheter is a cause of superior vena cava syndrome that is not routinely encountered by emergency physicians. Diagnosis requires identifying patients at risk (e.g., those under treatment for cancer and those who have a tunnelled central venous catheter), recognizing the signs and symptoms of superior vena cava syndrome, usually dyspnea and dilated neck or thoracic veins, and imaging the venous obstruction using computer tomography or sonography. Management involves anticoagulation and local thrombolytic administration. We report the case of a 28-year-old woman who presented with a 2-day history of face, chest and bilateral arm swelling who had been receiving maintenance chemotherapy for acute lymphoblastic leukemia through a Hickman® catheter. This case demonstrates the need to be vigilant for thrombus formation in patients with long-term, indwelling central venous catheters.

scholarly journals Endovascular retrieval of two migrated stents from pulmonary artery by means of balloon catheter

2021 ◽  
Vol 5 ◽  
pp. 21
Author(s):  
Saad Saeed Alqahtani ◽  
Ahmed Kandeel Elhadad ◽  
Rusha Abdulmohsen Sarhan ◽  
Saleh Mohamed Alwaleedi
Keyword(s):  
Pulmonary Artery ◽  
Superior Vena ◽  
Balloon Catheter ◽  
Vena Cava ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Venous Stenting ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
The Right

Long-term central venous catheters can be associated with central venous stenosis in up to 50% of cases. Central venous stenosis can be managed with central venous stenting which was demonstrated to restore patency and improve suboptimal results after percutaneous transluminal angioplasty. Dislodgment of venous stents into the right side of the heart or the pulmonary artery during stent deployment is one of the most feared complications of this procedure. Percutaneous removal of these migrated stents is the preferred alternative for the more invasive operative intervention, which may be very hazardous in these patients. We report an unusual case of a 52-year-old man on hemodialysis who underwent endovascular stenting to treat a tight stenosis of the right brachiocephalic vein and superior vena cava and suffered from stent migration to the left pulmonary artery, requiring removal by interventional radiologist.

scholarly journals Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond

2017 ◽  
Vol 34 (04) ◽  
pp. 398-408 ◽  
Author(s):  
Tamir Friedman ◽  
Keith Quencer ◽  
Sirish Kishore ◽  
Ronald Winokur ◽  
David Madoff
Keyword(s):  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Venous Obstruction ◽  
Central Venous ◽  
Vena Cava Syndrome

AbstractVenous obstruction in the cancer population can result in substantial morbidity and, in extreme cases, mortality. While venous obstruction can be caused by both benign and malignant etiologies in this population, the management of malignant venous obstruction as a palliative measure can be somewhat nuanced with respect to nonprocedural and procedural management, both with respect to treatment of the underlying malignancy as well as treatment of venous hypertension, which may be associated with venous thrombosis. Symptom severity, primary malignancy, functional status, and prognosis are all fundamental to the patient workup and dictate both the timing and extent of endovascular intervention. The morbidity and mortality associated with malignant obstructions of central venous structures, specifically the superior vena cava and inferior vena cava, can be significantly improved with endovascular management in appropriately selected patients. Thus, the pertinent literature regarding the clinical presentation, workup, and endovascular management of malignant central venous obstruction syndromes, with directed attention to superior vena cava syndrome and inferior vena cava syndrome, will be reviewed in this article.

Management of Superior Vena Cava Occlusion Causing Bleeding “Downhill” Esophageal Varices

2021 ◽  
pp. 152660282198933
Author(s):  
Pablo V. Uceda ◽  
Julio Peralta Rodriguez ◽  
Hernán Vela ◽  
Adelina Lozano Miranda ◽  
Luis Vega Salvatierra ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Esophageal Varices ◽  
Superior Vena ◽  
Vena Cava ◽  
Central Venous Catheters ◽  
Dialysis Patients ◽  
Central Venous ◽  
Endovascular Recanalization ◽  
Flow Through ◽  
The Right

The health care system in Peru treats 15,000 dialysis patients annually. Approximately 45% of patients receive therapy using catheters. The incidence of catheter-induced superior vena cava (SVC) occlusion is increasing along with its associated significant morbidity and vascular access dysfunction. One of the unusual manifestations of this complication is bleeding “downhill” esophageal varices caused by reversal of blood flow through esophageal veins around the obstruction to the right atrium. Herein is presented the case of an 18-year-old woman on hemodialysis complicated by SVC occlusion and bleeding esophageal varices who underwent successful endovascular recanalization of the SVC. Bleeding from “downhill” esophageal varices should be considered in the differential diagnosis of dialysis patients exposed to central venous catheters. Aggressive endovascular treatment of SVC occlusion is recommended to preserve upper extremity access function and prevent bleeding from this complication.

Electrosurgical Removal of a Central Venous Catheter Inadvertently Sutured Into the Superior Vena Cava

2021 ◽  
Author(s):  
Sandeep Arunothayaraj ◽  
Kristoffer Tanseco ◽  
Anna-Lucia Koerling ◽  
Andrew Hill ◽  
Jonathon Hyde ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous

Persistent Left Superior Vena Cava in Pediatric Patients

2009 ◽  
Vol 10 (3) ◽  
pp. 219-220 ◽  
Author(s):  
Marco Caruselli ◽  
Gianmarco Piattellini ◽  
Gianfranco Camilletti ◽  
Roberto Giretti ◽  
Raffaella Pagni
Keyword(s):  
Superior Vena Cava ◽  
Pediatric Patients ◽  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Superior Vena ◽  
Vena Cava ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Venous Catheterization

A persistent left superior vena cava (PLSVC) is a congenital anomaly of the systemic venous system. This anomaly is often discovered as an incidental result during central venous catheterization passing through the left subclavian or the left internal jugular vein. We report two cases of PLSVC in pediatric patients.

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