CardioVascular and Interventional Radiology

, Volume 26, Issue 6, pp 576–579 | Cite as

Permanent Pacemaker-Induced Superior Vena Cava Syndrome: Successful Treatment by Endovascular Stent

  • Carlos Lanciego
  • Mario Rodriguez
  • Adela Rodriguez
  • Miguel A. Carbonell
  • Lorenzo García García
Case Report


The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later.


Stents and prostheses—pacemakers—vena cava stenosis or obstruction 



The authors thank Dr. Peter R. Turner of t-SciMed (Reus, Spain) for editorial assistance.


  1. 1.
    Francis, CM, Starkey, IR, Errington, ML, Gillespie, IN 1995Venous stenting as treatment for pacemaker-induced superior vena cava syndrome.Am Heart J129836837PubMedGoogle Scholar
  2. 2.
    Lindsay, HS, Chennells, PM, Perrins, EJ 1994Successful treatment by balloon venoplasty and stent insertion of obstruction of the superior vena cava by an endocardial pacemaker lead.Br Heart J71363365PubMedGoogle Scholar
  3. 3.
    Murakami, Y, Matsuno, Y, Izumi, S,  et al. 1990Superior vena cava syndrome as a complication of DDD pacemaker implantation.Clin Cardiol13298300PubMedGoogle Scholar
  4. 4.
    Kastner, RJ, Fisher, WG, Blacky, AR, Bacon, ME 1996Pacemaker-induced superior vena cava syndrome with successful treatment by balloon venoplasty.Am J Cardiol77789790CrossRefPubMedGoogle Scholar
  5. 5.
    Slonim, SM, Semba, CP, Sze, DY, Dake, MD 2000Placement of SVC stents over pacemaker wires for the treatment of SVC syndrome.J Vasc Interv Radiol11215219PubMedGoogle Scholar
  6. 6.
    Pavia, S, Wilkoff, B 2001The management of surgical complications of pacemaker and implantable cardioverter-defibrillators.Curr Opin Cardiol166671CrossRefPubMedGoogle Scholar
  7. 7.
    Goudevenos, JA, Reid, PG, Adams, PC, Holden, MP, Williams, DO 1989Pacemaker- induced superior vena cava syndrome: report of four cases and a review of the literature.Pacing Clin Electrophysiol1218901895PubMedGoogle Scholar
  8. 8.
    Mazzetti, H, Dussuat, A, Tentori, C, Dussuat, E, Lazzari, JO 1993Superior vena cava occlusion and/or syndrome related to pacemaker leads.Am Heart J125831837CrossRefPubMedGoogle Scholar
  9. 9.
    Lin, CT, Kuo, CT, Lin, KH, Hsu, TS 1999Superior vena cava syndrome as a complication of transvenous permanent pacemaker implantation.Jpn Heart J40477480CrossRefPubMedGoogle Scholar
  10. 10.
    Kataoka, H 1997Ten-year follow-up of a patient with pacemaker-induced superior vena cava syndrome.Pacing Clin Electrophysiol2017341736PubMedGoogle Scholar
  11. 11.
    Peñalver, N, Worner, F, San Jose, A, Selva, A, Ordi, J, Arderiu, A 1991A superior vena cava syndrome secondary to intracavitary pacemakers. The diagnostic and therapeutics aspects.Rev Esp Cardiol44491493PubMedGoogle Scholar
  12. 12.
    Yoon, J, Kh, KK, Cho, SK, Kim, SS, Jin, SH 1993Superior vena cava syndrome after repeated insertion of transvenous pacemaker.Am Heart J12610141015CrossRefPubMedGoogle Scholar
  13. 13.
    Chia, HY, Anderson, D, Jackson, G 1999Pacemaker-induced superior vena cava: by-pass using the intact azygous vein.Pacing Clin Electrophysiol22536537PubMedGoogle Scholar
  14. 14.
    Odell, JA, Keeton, GR, Scott Millar, RN, Beningfield, SJ 1995Pacemaker-induced superior vena cava obstruction: management by spiral vein graft.Pacing Clin Electrophysiol18739742PubMedGoogle Scholar
  15. 15.
    Marzo, KP, Schwartz, R, Glanz, S 1995Early restenosis following percutaneous transluminal balloon angioplasty for the treatment of the superior vena caval syndrome due to pacemaker-induced stenosis.Cathet Cardiovasc Diagn36128131PubMedGoogle Scholar
  16. 16.
    Cleveland, TJ, Beard, JD, Gaines, PA 1997Case report: stenting of the SVC without removal of a long-term central feeding line.Clin Radiol52314316PubMedGoogle Scholar
  17. 17.
    Hemphill, DJ, Sniderman, KW, Allard, JP 1996Management of total prenteral nutrition-related superior vena cava obstruction with expandable metal stents.J Parenter Enteral Nutr20222227Google Scholar
  18. 18.
    Petersen, BD, Uchida, BT 1999Long-term results of treatment of benign central venous obstructions unrelated to dialysis with expandable Z stents.J Vasc Interv Radiol10757766PubMedGoogle Scholar
  19. 19.
    Doods, GA, Harrison, JK, O’Laughlin, MP, Wilson, JS, Kisslo, KB, Bashore, TM 1994Relief of superior vena cava syndrome due to fibrosing mediastinitis using the Palmaz stent.Chest106315318PubMedGoogle Scholar
  20. 20.
    Nicholson, AA, Ettles, DF, Arnold, A, Greenstone, M, Dyet, JF 1997Treatment of malignant superior vena cava obstruction: metal stents or radiation therapy.J Vasc Interv Radiol8781788PubMedGoogle Scholar
  21. 21.
    Lanciego, C, Chacón, JI, Julián, A,  et al. 2001Stenting as first option for endovascular treatment of malignant superior vena cava syndrome.AJR177585593PubMedGoogle Scholar
  22. 22.
    Melikian, N, Brookes, CI, Rickards, AF 1999Management of superior vena cava obstruction secondary to a pacing wire with percutaneous intravascular stent insertion.Heart82182PubMedGoogle Scholar
  23. 23.
    Kai, H, Honma, T, Imaizumi, T 2001Superior vena cava syndrome caused by multiple pacing leads.Heart8630CrossRefGoogle Scholar
  24. 24.
    Teo, N, Sabharwal, T, Rowland, E, Curry, P, Adam, A 2002Treatment of superior vena cava obstruction secondary to pacemaker wires with balloon venoplasty and insertion of metallic stents.Eur Heart2314651470CrossRefGoogle Scholar
  25. 25.
    Rosenthal, E, Qureshi, SA, Tynan, M, Bucknall, CA 1996Percutaneous pacemaker lead extraction and stent implantation for superior vena cava occlusion due to pacemaker leads.Am J Cardiol77670672CrossRefPubMedGoogle Scholar
  26. 26.
    Oudkerk, M, Kuijpers, T, Schmitz, P 1996Self-expanding metal stents for palliative treatment of superior vena cava syndrome.Cardiovasc Intervent Radiol19146151CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 2003

Authors and Affiliations

  • Carlos Lanciego
    • 1
  • Mario Rodriguez
    • 2
  • Adela Rodriguez
    • 3
  • Miguel A. Carbonell
    • 3
  • Lorenzo García García
    • 1
  1. 1.Unit of Interventional RadiologyHospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, ToledoSpain
  2. 2.Unit of Intensive CareHospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, ToledoSpain
  3. 3.Unit of GeriatricsHospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, ToledoSpain

Personalised recommendations