Watkinson A F, Hansell D M
Department of Radiology, Royal Brompton National Heart and Lung Hospital, London.
Thorax. 1993 Sep;48(9):915-20. doi: 10.1136/thx.48.9.915.
Palliative treatments for obstruction of the superior vena cava all have disadvantages. The use of a fine braided wire self expanding stent (Wallstent, Schneider (Europe) AG) in patients with malignant and benign causes of superior vena cava obstruction is reported.
Five patients with obstruction of the superior vena cava were treated with balloon angioplasty of the stricture and the percutaneous insertion of an expandable Wallstent endoprosthesis across the site of the stricture. Four patients had advanced mediastinal malignancy previously treated by radiotherapy and one patient had fibrosing mediastinitis.
All patients experienced rapid symptomatic relief and, in three cases, complete palliation was achieved during survival times of seven weeks, nine weeks, and 24 weeks, respectively. Two surviving patients (with a recurrent thymoma and fibrosing mediastinitis) were free of symptoms when followed up at eight and nine months respectively.
Initial experience with the Wallstent endoprosthesis suggests that it is a valuable treatment alternative once conventional therapy has failed and gives rapid relief of symptoms to patients with obstruction of the superior vena cava.
上腔静脉阻塞的姑息治疗均存在不足之处。本文报道了在患有恶性和良性上腔静脉阻塞病因的患者中使用一种精细编织的金属丝自膨式支架（Wallstent，施奈德（欧洲）股份公司）的情况。
对5例上腔静脉阻塞患者进行狭窄部位的球囊血管成形术，并经皮在狭窄部位植入可扩张的Wallstent内支架。4例患者患有晚期纵隔恶性肿瘤，此前接受过放疗，1例患者患有纤维性纵隔炎。
所有患者症状均迅速缓解，其中3例分别在7周、9周和24周的生存期内实现了完全缓解。2例存活患者（分别患有复发性胸腺瘤和纤维性纵隔炎）在分别随访8个月和9个月时无症状。
Wallstent内支架的初步经验表明，一旦传统治疗失败，它是一种有价值的治疗选择，能迅速缓解上腔静脉阻塞患者的症状。
