Thony F, Moro D, Ferretti G, Ranchoup Y, Witmeyer P, Brambilla C, Coulomb M
Service Central de Radiologie et Imagerie médicale, CHU Grenoble.
Rev Mal Respir. 1999 Nov;16(4 Pt 2):731-43.
Endovascular therapies represent the most efficient treatment of benign or malignant obstructions of the superior vena cava. The indication of stenting in case of malignant obstruction depends on the severity of the superior vena cava syndrome, the histological type of the tumor, and the response to radiotherapy and chemotherapy. Restoration of the superior vena cava patency is obtained in more than 90% of cases, with persistent good mid and long term results. Complications are rare, especially after early treatment. Stenting of benign obstructions, especially in patients who undergo hemodialysis, allows to restore venous accesses. However, indication of treatment may be discussed because the initial and late patencies are lower than in malignant obstructions.
血管内治疗是上腔静脉良性或恶性梗阻最有效的治疗方法。恶性梗阻时支架置入的指征取决于上腔静脉综合征的严重程度、肿瘤的组织学类型以及对放疗和化疗的反应。超过90%的病例可恢复上腔静脉通畅,中长期效果持续良好。并发症罕见,尤其是早期治疗后。良性梗阻的支架置入,特别是在接受血液透析的患者中,可恢复静脉通路。然而,由于初始和晚期通畅率低于恶性梗阻,治疗指征可能需要讨论。