Branched Stent Graft Placement in the Vena Cava Using the Endologix AFX

Superior vena cava syndrome (SVCS) comprises a constellation of symptoms resulting from stenosis, occlusion, or thrombosis of the SVC of benign and malignant etiologies. The diagnosis is most commonly seen with thoracic malignancies, with primary lung cancer accounting for up to 70% of cases. Up to 4% of lung cancer patients present with SVCS at the time of diagnosis, and many more develop it at a later time. In younger patients with SVCS, lymphoma is commonly responsible. Recently, there has been a rise in benign SVCS secondary to the increased use of central venous catheters and pacemakers. Endovascular stenting of the SVC for SVCS has been described for more than 25 years and is now the first-line treatment of choice for benign and malignant SVCS. This chapter describes the use of the Endologix AFX AAA system for the treatment of SVCS.