What is the efficacy of anticoagulation therapy for superior vena cava syndrome (SVCS)?

Updated: Mar 26, 2018
  • Author: Todd A Nickloes, DO, FACOS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

In a 1988 report, Adelstein et al discussed prophylaxis against embolic events in the presence of SVC obstruction in the management of 25 patients with malignant SVCS. [28] Ten patients were retrospectively reviewed after having been diagnosed clinically without venography and treated without anticoagulation. Five thromboembolic complications occurred, two of which proved fatal.

Fifteen patients were prospectively evaluated by means of angiography and then treated with anticoagulants. [28] Angiographic evidence of intraluminal subclavian vein or SVC thrombosis was found in five of these patients, and no thromboembolic complications occurred. Of the 20 patients who were ultimately given anticoagulation therapy, two had fatal intracranial hemorrhages. The authors suggested that randomized prospective trials would be needed to determine the roles of venography and anticoagulation in the management of SVCS.


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