The use of metallic stents in the treatment of malignant superior vena caval obstruction.

Superior vena caval obstruction due to malignancy is conventionally treated by radiotherapy and/or chemotherapy. In patients with unresolved or recurrent obstruction after treatment, expandable metallic stents can be percutaneously placed within the vena cava for relief of symptoms. In this series, metallic stents were successfully deployed in 11 consecutive patients with bronchial carcinoma. Gianturco Z stents were used in 10 patients and Strecker stents in one. There were 2 minor procedural complications of no sequelae. All patients had partial or full relief of symptoms after the procedure. On follow-up (mean 3.9 months), 9 patients had no recurrent symptoms up till the time of death or the present time. Two patients had recurrent obstruction, both within a week of the procedure. Based on our experience, percutaneous stenting was an effective means of palliation in this group of patients when other treatment modalities failed.