What is the efficacy of endovascular therapies 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

A 2016 study by Breault et al reported that the use of percutaneous endovascular techniques to treat benign SVCS yielded good long-term patency, with recurrences easily addressable by repetition of the procedure. [35]

A 2017 review by Sfyroeras et al examined the results of open (four studies; N=87) and endovascular (nine studies; N=136) treatment of benign SVCS. [36] Endovascular interventions included percutaneous transluminal angioplasty (PTA) and stenting (73.6%); PTA only (17.3%); and thrombolysis, PTA, and stenting (9%). Open procedures included spiral saphenous interposition graft, other vein graft, PTFE graft, and human allograft.

In this review, the technical success rate in the endovascular group was 95.6%, the 30-day mortality was 0%, 97.3% of patients reported symptom regression, and 26.9% underwent secondary procedures (58 secondary procedures in total). [36] The 30-day mortality in the open group was 0%, 93.5% of patients reported symptom regression, and 28.4% underwent secondary procedures (33 secondary procedures in total).

The use of endovascular therapy for SVCS of malignant origin has been discussed by del Río Solá et al. [37]

Cases of excimer laser removal of pacemaker leads followed by venoplasty and stenting have been reported. [38]


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