Sun Kaiwen, Batra Rishi, Markin Nicholas W, Suh Melissa, Pipinos Iraklis I, Roberts Ellen K, Mactaggart Jason N, Baxter B Timothy
1 College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
2 Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Vasc Endovascular Surg. 2017 Nov;51(8):562-566. doi: 10.1177/1538574417723157. Epub 2017 Oct 10.
Obstruction of the superior vena cava (SVC) is an uncommon, but potentially life-threatening condition due to likely development of edema in the head and neck and potential respiratory compromise. Less than half of those affected by SVC syndrome survive more than a year. Obstruction can be from neoplasms or secondary to benign disease. Treatment for most cases of symptomatic SVC syndrome involves placement of a stent to relieve the stenosis. Serious complications such as stent migration, pulmonary embolism, and cardiac tamponade can occur in 5% to 10% of cases, and inadequate imaging of the SVC-atrial junction by fluoroscopy contributes to these problems. The overlapping contrast in the atrium makes it difficult to precisely place the distal end of the stent, potentially allowing for embolization of the stent to occur. We present a case series of 3 patients wherein transesophageal echocardiography was used for guidance of stent placement in the SVC and significantly aided in placement.
上腔静脉（SVC）梗阻是一种罕见但可能危及生命的病症，因为头颈部可能会出现水肿并有可能导致呼吸功能受损。受上腔静脉综合征影响的患者中，存活超过一年的不到一半。梗阻可能由肿瘤引起，也可能继发于良性疾病。大多数有症状的上腔静脉综合征病例的治疗方法是放置支架以缓解狭窄。5%至10%的病例可能会出现严重并发症，如支架移位、肺栓塞和心脏压塞，而透视对上腔静脉-心房交界处的成像不足会导致这些问题。心房内造影剂重叠使得难以精确放置支架远端，从而可能导致支架栓塞。我们报告了3例病例系列，其中经食管超声心动图用于指导上腔静脉支架置入，并在置入过程中提供了显著帮助。
