MANAGEMENT OF SUPERIOR VENA CAVA SYNDROME IN LUNG CANCER PATIENTS BY STENT ASSISTED ANGIOPLASTY: A RETROSPECTIVE SINGLE CENTER STUDY

Abstract

Background: Superior vena cava (SVC) syndrome refers to the constellation of clinical manifestations caused by obstruction of blood flow through SVC. Malignant obstruction can be caused by direct invasion of tumor into the SVC, or by external compression of the SVC by an adjacent pathologic process involving the right lung, lymph nodes, and other mediastinal structures, leading to stagnation of flow and thrombotic obstruction, which can be managed by Stent assisted SVC angioplasty

Aim of the study: This study aims to retrospectively evaluate the safety and effectiveness of the Stent assisted SVC angioplasty in the treatment of SVC syndrome caused by lung cancer as a palliative procedure.

Materials and Methods: Clinical and radiological records of all patients presenting with SVC syndrome and symptoms of facial swelling & dyspnea who underwent stent assisted angioplasty at our center between November 2022 to August 2024 were analyzed. 12 such cases were identified and all details were noted and assessed.

CT angiography or DSA (digital subtraction angiography) was done to calculate the length of involvement and diameter of the landing zone.  When necessary, suction thrombectomies were executed prior to stent deployment. Stent assisted SVC angioplasty was performed via either internal jugular vein (IJV) in SVC from distal to proximal landing zone. Post procedure DSA in two orthogonal planes was obtained to confirm the patency of the stent.

Conclusion: Endovascular stenting is very effective in the treatment of SVC syndrome by establishment of patent blood flow and amelioration of the clinical manifestations. Relief of symptoms (facial swelling and dyspnea) occurred within 24 hours after the SVC stenting in all patients.