Endovascular Stenting as the First Step in the Overall Management of Malignant Superior Vena Cava Syndrome

OBJECTIVE. Self-expandable metal stents were inserted in cancer patients with superior vena cava (SVC) syndrome to assess their effectiveness as a primary treatment for symptom relief.SUBJECTS AND METHODS. Between January 1993 and June 2008, Wallstent prostheses (n = 208) were inserted in 149 cancer patients (137 men, 12 women; median age, 65 years; age range, 44-84 years) diagnosed as having SVC syndrome. A single stent was sufficient to restore vessel patency in 102 patients, two stents in 36, three stents in 10, and four stents in one. Survival data were calculated using Kaplan-Meier curves and multivariate analysis using the Cox regression method.RESULTS. Complete resolution of symptoms was achieved in 123 patients within 72 hours, partial resolution in 22 patients, and no response in only four patients. At follow-up, 30 complications were noted: 16 obstructions, four cases of thrombosis, one partial stent migration to the right atrium, two cases of incorrect stent placement, six stent “shortenings,” ...