Kennedy David P, Palit Tapash K
Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana 70112, USA.
Ann Vasc Surg. 2010 May;24(4):555.e7-555.e12. doi: 10.1016/j.avsg.2009.12.007. Epub 2010 Apr 3.
Superior vena cava (SVC) syndrome due to benign disease requires prompt and durable treatment because affected patients frequently have long life expectancies. While conservative management with head elevation and anticoagulation are first-line treatments, refractory symptoms may warrant intervention. The two main invasive treatments are percutaneous endovascular repair and open surgical reconstruction. Both have demonstrated efficacy over the mid term, but surgical reconstruction is the only method with proved patency over the long term. This report documents a case of a 26-year-old woman with SVC syndrome secondary to long-term indwelling central venous catheterization. SVC bypass was performed using the superficial femoral vein, and near-complete resolution of symptoms occurred within 1 week. Superficial femoral vein is a versatile conduit for SVC reconstruction and a useful alternative to spiral saphenous vein grafts, although mid- and long-term patency rates must be further studied.
由于良性疾病导致的上腔静脉(SVC)综合征需要迅速且持久的治疗,因为受影响的患者通常预期寿命较长。虽然将头部抬高和抗凝的保守治疗是一线治疗方法,但难治性症状可能需要进行干预。两种主要的侵入性治疗方法是经皮血管腔内修复和开放手术重建。两者在中期均已证明有效,但手术重建是唯一长期通畅得到证实的方法。本报告记录了一名26岁女性因长期留置中心静脉导管继发SVC综合征的病例。使用股浅静脉进行了SVC搭桥术,症状在1周内几乎完全缓解。股浅静脉是用于SVC重建的多功能管道,是螺旋大隐静脉移植物的有用替代方法,尽管中长期通畅率仍需进一步研究。