Department of Cardiology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Ann Vasc Surg. 2022 Mar;80:325-332. doi: 10.1016/j.avsg.2021.10.025. Epub 2021 Nov 12.
We assessed the safety as well as the efficacy of self-expanding stent placement for the treatment of malignant superior vena cava syndrome (SVCS), besides identifying the predictable probable factors for the clinical improvement of endovascular stent treatment in SVCS.
The study reviewed 112 patients (92 men) with malignant SVCS retrospectively from January 2015 to December 2020.
Out of total 112 patients, 106 stents were successfully placed in 102 patients, however 4 patient's occlusions could not be passed and 6 patient's procedure was abandoned due to intraluminal thrombus as detected in venography. In 92 patients, complete resolution of syndrome was observed within 72 hrs but 10 patients did not to intervention. In 102 patients, procedure-related 8 complications were noted including stent migrations (n = 4), pulmonary embolism (n = 2), and pulmonary edemas (n = 2). Besides after stenting, 3 hemorrhages with anticoagulation therapy were observed with 4 recurrences at 22, 36, 51 and day 58 in 6 months. The pressure gradient across the lesion (≥ 20mmHg) was used as a predictor for clinical efficacy of stent therapy for SVCS.
Endovascular stent insertion is a safe and effective intervention for malignant SVCS, especially for those with pressure gradient across the lesions ≥ 20mmHg.
我们评估了自膨式支架置入治疗恶性上腔静脉综合征（SVCS）的安全性和疗效，并确定了预测 SVCS 血管内支架治疗临床改善的可能因素。
本研究回顾性分析了 2015 年 1 月至 2020 年 12 月期间 112 例（92 例男性）恶性 SVCS 患者的资料。
在 112 例患者中，102 例患者成功放置了 106 枚支架，但 4 例患者的支架无法通过堵塞部位，6 例患者因静脉造影显示管腔内血栓而放弃手术。92 例患者在 72 小时内综合征完全缓解，但 10 例患者未接受干预。在 102 例患者中，发生与操作相关的 8 种并发症，包括支架移位（n=4）、肺栓塞（n=2）和肺水肿（n=2）。此外，在支架置入后，抗凝治疗观察到 3 例出血，6 个月内有 4 例复发，分别在第 22、36、51 和 58 天。病变处压力梯度（≥20mmHg）被用作支架治疗 SVCS 临床疗效的预测因素。
血管内支架置入术是治疗恶性 SVCS 的一种安全有效的方法，尤其是对病变处压力梯度≥20mmHg 的患者。
