Duvnjak S, Andersen P
Department of Radiology, Odense University Hospital, Odense, Denmark.
Int Angiol. 2011 Oct;30(5):458-61.
The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome.
Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented clinically with superior vena cava syndrome and according caval stenosis confirmed by computed tomography. The causes of stenoses were non-small cell carcinoma in 22 patients and small cell carcinoma in 8 patients.
In all patients the stents were placed as intended in all patients there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications. All patients were followed clinically till death and the median follow-up period was 2.8 months (15-420 days). During follow-up three cases of stent thrombosis (one complete and two partial thrombosis) were observed.
Palliative care with stent implantation for superior vena cava syndrome is a minimal invasive and safe procedure with good clinical effect giving the patients a significant better quality of their residual life.
本研究旨在报告我们采用姑息性支架治疗上腔静脉综合征的经验。
2008年1月至2009年12月期间,30例(平均年龄60.7岁)因上腔静脉狭窄接受支架治疗。所有患者临床上均表现为上腔静脉综合征,且经计算机断层扫描证实存在腔静脉狭窄。狭窄原因包括22例非小细胞癌和8例小细胞癌。
所有患者的支架均按计划置入,所有患者临床症状立即改善,上肢和头部水肿明显减轻。然而,5例患者(17%)仍持续存在呼吸困难,2例患者(7%)上胸部可见持续的侧支静脉循环。未发生与支架相关的并发症。所有患者均接受临床随访直至死亡,中位随访期为2.8个月(15 - 420天)。随访期间观察到3例支架血栓形成(1例完全血栓形成和2例部分血栓形成)。
对上腔静脉综合征进行支架植入姑息治疗是一种微创且安全的手术,临床效果良好,能显著提高患者剩余生命的质量。