Radiation-induced superior vena cava syndrome.

A 59-year-old man developed superior vena caval obstruction 20 years after receiving a radiation treatment for primary germinal cell tumor of the mediastinum. Venous decompression was achieved by anastomosing a 10-mm ringed polytetrafluoroethylene graft from the left internal jugular vein to the right atrium, which yielded immediate relief of symptoms. A left internal jugular venogram demonstrated graft patency 11 months post-operatively, and the patient remained free of symptoms of superior vena caval obstruction 29 months postoperatively.