Contenido principal del artículo
Introduction: superior vena cava syndrome results from an obstruction of blood flow through this vessel. Currently, almost all cases are associated with malignancies. There are controversies about the optimal management of this syndrome. Endovascular therapies are considered the first-line therapy.
Material and methods: we collected clinical, laboratory and pharmacological data from patients admitted at the Hospital Italiano de Buenos Aires, between January 1st and November 1st 2021 with a diagnosis o superior vein cava syndrome. Baseline characteristics, treatment strategies and clinical outcomes were recorded.
Results: a total of five patients were included in the present study. All cases were malignancy-related. Most of the patientsdeveloped moderate symptoms. Four out of five patients were treated with endovascular therapies and two patients died during hospitalization.
Discussion: controversies regarding optimal management of the superior vena cava syndrome remain. Future research should focus on identifying those patients who are most likely to benefit from endovascular, anticoagulant or antiplatelet therapeutic strategies.
Detalles del artículo
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med. 2007;356(18):1862-1869. https://doi.org/10.1056/NEJMcp067190. Errata en: N Engl J Med. 2008;358(10):1083.
Danias PG, Pipilis AG. Superior vena cava syndrome: 1757-2007. Hellenic J Cardiol. 2007;48(6):366-367.
Yu JB, Wilson LD, Detterbeck FC. Superior vena cava syndrome--a proposed classification system and algorithm for management. J Thorac Oncol. 2008;3(8):811-814. https://doi.org/10.1097/JTO.0b013e3181804791.
Holliday EB, Hampton DA, Thomas CR Jr, et al. Prognostic value of the Yale Grading System for superior vena cava syndrome. Ann Am Thorac Soc. 2016 Oct;13(10):1862-1865. https://doi.org/10.1513/AnnalsATS.201605-412LE.
Cohen R, Mena D, Carbajal-Mendoza R, et al. Superior vena cava syndrome: a medical emergency? Int J Angiol. 2008;17(1):43-46. https://doi.org/10.1055/s-0031-1278280.
Schraufnagel DE, Hill R, Leech JA, et al. Superior vena caval obstruction: is it a medical emergency? Am J Med. 1981;70(6):1169-1174. https://doi.org/10.1016/0002-9343(81)90823-8.
García Mónaco R, Bertoni H, Pallota G, et al. Use of self-expanding vascular endoprostheses in superior vena cava syndrome. Eur J Cardiothorac Surg. 2003;24(2):208-211. https://doi.org/10.1016/s1010-7940(03)00293-8.
Friedman T, Quencer KB, Kishore SA, et al. Malignant venous obstruction: superior vena cava syndrome and beyond. Semin Intervent Radiol. 2017;34(4):398-408. https://doi.org/10.1055/s-0037-1608863.
Loeffler JS, Leopold KA, Recht A, et al. Emergency prebiopsy radiation for mediastinal masses: impact on subsequent pathologic diagnosis and outcome. J Clin Oncol. 1986;4(5):716-721. https://doi.org/10.1200/JCO.19188.8.131.526.
Nicholson AA, Ettles DF, Arnold A, et al. Treatment of malignant superior vena cava obstruction: metal stents or radiation therapy. J Vasc Interv Radiol. 1997;8(5):781-788. https://doi.org/10.1016/s1051-0443(97)70660-2.
Azizi AH, Shafi I, Zhao M, et al. Endovascular therapy for superior vena cava syndrome: a systematic review and meta-analysis. EClinicalMedicine. 2021;37:100970. https://doi.org/10.1016/j.eclinm.2021.100970.
Fagedet D, Thony F, Timsit JF, et al. Endovascular treatment of malignant superior vena cava syndrome: results and predictive factors of clinical efficacy. Cardiovasc Intervent Radiol. 2013;36(1):140-149. https://doi.org/10.1007/s00270-011-0310-z