Crusio Robbert, Ramachandran Kishan, Ramachandran Kavan, Kupfer Yizhak, Tessler Sidney
Department of Medicine, Division of Pulmonary & Critical Care Medicine, Maimonides Medical Center, Brooklyn, New York, USA.
BMJ Case Rep. 2011 Feb 14;2011:bcr1120103502. doi: 10.1136/bcr.11.2010.3502.
Superior vena cava syndrome (SVCS) is usually caused by a malignancy or the presence of an intravascular device in a central vein. A 74-year-old male with a history of a superior vena cava (SVC) stent underwent embolisation of a brain arterio-venous malformation through the right meningeal artery with liquid Onyx. Two weeks later he presented with acute respiratory failure, upper airway obstruction, plethora, varices of the chest wall and stridor. He was intubated and placed on mechanical ventilatory support. Chest imaging revealed a linear structure in the SVC, extending to the right atrium. Interventional radiology removed the material, which was determined to be liquid Onyx. Venous pressures of the right internal jugular vein decreased after removal of the material. The symptoms resolved and patient was successfully extubated. This is the first reported case of SVCS caused by liquid Onyx.
上腔静脉综合征（SVCS）通常由恶性肿瘤或中心静脉内存在血管内装置引起。一名74岁男性，有上腔静脉（SVC）支架置入史，通过右脑膜动脉用液体栓塞剂Onyx对脑动静脉畸形进行了栓塞治疗。两周后，他出现急性呼吸衰竭、上呼吸道梗阻、面部潮红、胸壁静脉曲张和喘鸣。他接受了气管插管并接受机械通气支持。胸部影像学检查显示上腔静脉内有一线性结构，延伸至右心房。介入放射学取出了该物质，经确定为液体栓塞剂Onyx。取出该物质后，右颈内静脉的静脉压下降。症状缓解，患者成功拔管。这是首例报道的由液体栓塞剂Onyx引起的上腔静脉综合征病例。
