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CardioVascular and Interventional Radiology

, Volume 34, Issue 3, pp 667–671 | Cite as

Successful Treatment of Superior Vena Cava Rupture with Placement of a Covered Stent: A Report of Two Cases

  • Ryan Jean-Baptiste
  • David M. Williams
  • Joseph J. Gemmete
Letter to the Editor

Introduction

Superior vena cava syndrome (SVCS) is characterized by the development of symptoms, including facial, head, neck, chest, and upper extremity swelling, shortness of breath, and headache, in the setting of superior vena cava (SVC) stenosis or occlusion [1, 2]. SCVS may be caused by a variety of benign and malignant conditions. Since the development of self- and balloon-expandable stents, endovascular repair has become the first-line therapy for the treatment of SVCS [3, 4, 5]. The most common complications of stent placement include pulmonary embolus (PE), stent migration, fracture, and misplacement [6]. There are a few case reports describing subclinical rupture after stent placement and death secondary to cardiac tamponade from balloon dilatation of the SVC [7, 8]. Additionally, there is one case report describing the placement of a covered stent for superior vena cava rupture (SVCR) in a non-peer-reviewed journal [9]. We present two cases of SVCR during SVC balloon...

Keywords

Stent Placement Abciximab Superior Vena Cava Cardiac Tamponade Contrast Extravasation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Klassen KP, Andrews NC, Curtis GM (1951) Diagnosis and treatment of superior-vena-cava obstruction. AMA Arch Surg 63:311–325PubMedGoogle Scholar
  2. 2.
    Rice TW, Rodriguez RM, Light RW (2006) The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore) 85:37–42CrossRefGoogle Scholar
  3. 3.
    Lanciego C, Chacon JL, Julian A et al (2001) Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. AJR Am J Roentgenol 177:585–593PubMedGoogle Scholar
  4. 4.
    Rizvi AZ, Kalra M, Bjarnason H et al (2008) Benign superior vena cava syndrome: stenting is now the first line of treatment. J Vasc Surg 47:372–380PubMedCrossRefGoogle Scholar
  5. 5.
    Nagata T, Makutani S, Uchida H et al (2007) Follow-up results of 71 patients undergoing metallic stent placement for the treatment of a malignant obstruction of the superior vena cava. Cardiovasc Intervent Radiol 30:959–967PubMedCrossRefGoogle Scholar
  6. 6.
    Ansell G, Betteman MA, Kaufman JA, Wilkens RA (eds) (1996) Complications in diagnostic imaging and interventional radiology, 3rd edn. Blackwell Science, CambridgeGoogle Scholar
  7. 7.
    Brown KT, Getrajdman GI (2005) Balloon dilation of the superior vena cava (SVC) resulting in SVC rupture and pericardial tamponade: a case report and brief review. Cardiovasc Intervent Radiol 28:372–376PubMedCrossRefGoogle Scholar
  8. 8.
    Martin M, Baumgartner I, Kolb M, Triller J, Dinkel HP (2002) Fatal pericardial tamponade after Wallstent implantation for malignant superior vena cava syndrome. J Endovasc Ther 9:680–684PubMedCrossRefGoogle Scholar
  9. 9.
    Burkett MW (2003) Challenging cases: superior vena cava rupture. Endovasc Today 2:35–37Google Scholar
  10. 10.
    Lanciego C, Pangua C, Chacon JI et al (2009) Endovascular stenting as the first step in the overall management of malignant superior vena cava syndrome. AJR Am J Roentgenol 193:549–558PubMedCrossRefGoogle Scholar
  11. 11.
    Oshima K, Takahashi T, Ishikawa S et al (2006) Superior vena cava rupture caused during balloon dilation for treatment of SVC syndrome due to repetitive catheter ablation—a case report. Angiology 57:247–249PubMedCrossRefGoogle Scholar
  12. 12.
    Samuels LE, Nyzio JB, Entwistle JW (2007) Superior vena cava rupture during balloon angioplasty and stent placement to relieve superior vena cava syndrome: a case report. Heart Surg Forum 10:E78–E80PubMedCrossRefGoogle Scholar
  13. 13.
    Boardman P, Ettles DF (2000) Cardiac tamponade: a rare complication of attempted stenting in malignant superior vena caval obstruction. Clin Radiol 55:645–647PubMedCrossRefGoogle Scholar
  14. 14.
    Nguyen NP, Borok TL, Welsh J, Vinh-Hung V (2009) Safety and effectiveness of vascular endoprosthesis for malignant superior vena cava syndrome. Thorax 64:174–178PubMedCrossRefGoogle Scholar
  15. 15.
    Albrecht K, Nave H, Breitmeier D, Panning B, Troger HD (2004) Applied anatomy of the superior vena cava—the carina as a landmark to guide central venous catheter placement. Br J Anaesth 92:75–77PubMedCrossRefGoogle Scholar
  16. 16.
    Brant J, Peebles C, Kalra P, Odurny A (2001) Hemopericardium after superior vena cava stenting for malignant SVC obstruction: the importance of contrast-enhanced CT in the assessment of postprocedural collapse. Cardiovasc Intervent Radiol 24:353–355PubMedCrossRefGoogle Scholar
  17. 17.
    Azizzadeh A, Pham MT, Estrera AL, Coogan SM, Safi HJ (2007) Endovascular repair of an iatrogenic superior vena caval injury: a case report. J Vasc Surg 46:569–571PubMedCrossRefGoogle Scholar
  18. 18.
    Mesurolle B, Qanadli SD, Merad M et al (2000) Unusual radiologic findings in the thorax after radiation therapy. Radiographics 20:67–81PubMedGoogle Scholar
  19. 19.
    Da Ines D, Chabrot P, Motreff P et al (2010) Cardiac tamponade after malignant superior vena cava stenting: two case reports and brief review of the literature. Acta Radiol 51:256–259PubMedCrossRefGoogle Scholar
  20. 20.
    Smayra T, Otal P, Chabbert V et al (2001) Long-term results of endovascular stent placement in the superior caval venous system. Cardiovasc Intervent Radiol 24:388–394PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • Ryan Jean-Baptiste
    • 1
  • David M. Williams
    • 2
  • Joseph J. Gemmete
    • 3
  1. 1.Division of Vascular and Interventional Radiology, Department of RadiologyUniversity of Michigan Health System, Cardiovascular CenterAnn ArborUSA
  2. 2.Division of Vascular and Interventional Radiology, Department of RadiologyUniversity of Michigan Health System, Cardiovascular CenterAnn ArborUSA
  3. 3.Division of Vascular and Interventional Radiology, Department of RadiologyUniversity of Michigan Health SystemAnn ArborUSA

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