Figure 1
Teaching Case
SectionInterventional radiology
Case TypeClinical Cases
AuthorsBassetti E., Mangiapane F., Iafrate F., Marcelli G.,Rossi P
Connected authors
59 years, female
Patient presented himself on April 1993 with fever, dry cough, haematemesis. Thorax-MR showed a mass (4.6 x 5.3 cm) at the right anterior-superior mediastinum. The superior vena cava (SVC) was compressed. Two self-expandable stents were placed in SVC and in the left brachiocephalic trunk.
Mediastinic syndrome with compression of SVC and left brachiocephalic trunk.
The patient presented himself on April 1993 with fever, dry cough, haematemesis.
Bronchoscopy was performed with evidence of pulmunar microcitoma.
On January 1999 a Thorax-MR showed a mass (4.6 x 5.3 cm) at the right anterior-superior mediastinum.
The superior vena cava (SVC) was compressed and infiltrated at the confluence of the two brachiocephalic trunks.
The SVC flebography confirmed the strictures of the SVC and the left brachiocephalic trunk.
Therefore two "kissing" metallic self-expandable stents were placed in SVC and in the left brachiocephalic trunk.
The final flebography showed good flow through the stent of the right side,and a residual and no significant stenosis on the left side.
We decided to place metallic stents to mantain the patency of the vessels.
Self-expandable metallic stents are raccomended because of their high radial force.
The two stents were dilatated with a 10 mm balloon catheter, to garanty a complete dilatation of the strictures; anticoagulant drugs were administred to prevent a new stenosis.
It is also true that in some cases the only opening of one central vein is most sufficient to treat symptomps.
Periodic CT scan were performed for the follow-up.
References
[1]
Laing AD et al (1998)
Stenting in malignant and benign vena caval obstruction
Australas Radiol 42 (4): 313-7. (PMID: 9833367)
[2]
Tanigawa N et al (1998)
Clinical outcome of stenting in superior vena cava syndrome associated with malignant tumors. Comparison with conventional treatment
Acta Radiol 39 (6): 669-74. (PMID: 9817039)
[3]
Hochrein J et al (1998)
Percutaneous stenting of superior vena cava syndrome: a case report and review of the literature
Am J Med 104 (1): 78-84. (PMID: 9528723)
[4]
Entwisle KG (1996)
Case report: migration and shortening of a self-expanding metallic stent complicating the treatment of malignant superior vena cava stenosis
Clin Radiol 51 (8): 593-5. (PMID: 8761401)
Case information
| URL: | https://eurorad.org/case/159 |
| DOI: | 10.1594/EURORAD/CASE.159 |
| ISSN: | 1563-4086 |
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