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Semin intervent Radiol 2017; 34(04): 398-408
DOI: 10.1055/s-0037-1608863
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond

Tamir Friedman
1   Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
,
Keith B. Quencer
2   Department of Radiology, Division of Interventional Radiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Sirish A. Kishore
1   Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
,
Ronald S. Winokur
1   Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
,
David C. Madoff
1   Department of Radiology, Division of Interventional Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
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Publikationsdatum:
14. Dezember 2017 (online)

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Abstract

Venous obstruction in the cancer population can result in substantial morbidity and, in extreme cases, mortality. While venous obstruction can be caused by both benign and malignant etiologies in this population, the management of malignant venous obstruction as a palliative measure can be somewhat nuanced with respect to nonprocedural and procedural management, both with respect to treatment of the underlying malignancy as well as treatment of venous hypertension, which may be associated with venous thrombosis. Symptom severity, primary malignancy, functional status, and prognosis are all fundamental to the patient workup and dictate both the timing and extent of endovascular intervention. The morbidity and mortality associated with malignant obstructions of central venous structures, specifically the superior vena cava and inferior vena cava, can be significantly improved with endovascular management in appropriately selected patients. Thus, the pertinent literature regarding the clinical presentation, workup, and endovascular management of malignant central venous obstruction syndromes, with directed attention to superior vena cava syndrome and inferior vena cava syndrome, will be reviewed in this article.

Keywords

interventional radiology - venous obstruction - malignancy - lung cancer - stent - angioplasty
 

  • References

  • 1 Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med 2007; 356 (18) 1862-1869
    CrossrefPubMedGoogle Scholar
  • 2 Zisis C, Skevis K, Kefaloyannis EM, Avgoustou K, Bellenis I. Mediastinal tuberculous lymphadenitis presenting as superior vena cava syndrome. J Thorac Cardiovasc Surg 2006; 131 (06) e11-e12
    CrossrefPubMedGoogle Scholar
  • 3 Bandyopadhyay SK, Sarkar N, Ghosh S, Dasgupta S. Tubercular mediastinal lymphadenopathy presenting as superior vena cava syndrome. J Assoc Physicians India 2002; 50 (Sep): 1194-1195
    PubMedGoogle Scholar
  • 4 Phillips PL, Amberson JB, Libby DM. Syphilitic aortic aneurysm presenting with the superior vena cava syndrome. Am J Med 1981; 71 (01) 171-173
    CrossrefPubMedGoogle Scholar
  • 5 Kee ST, Kinoshita L, Razavi MK, Nyman UR, Semba CP, Dake MD. Superior vena cava syndrome: treatment with catheter-directed thrombolysis and endovascular stent placement. Radiology 1998; 206 (01) 187-193
    CrossrefPubMedGoogle Scholar
  • 6 Stevens DC, Butty S, Johnson MS. Superior vena cava rupture and cardiac tamponade complicating the endovascular treatment of malignant superior vena cava syndrome: a case report and literature review. Semin Intervent Radiol 2015; 32 (04) 439-444
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 7 Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore) 2006; 85 (01) 37-42
    CrossrefPubMedGoogle Scholar
  • 8 Urban T, Lebeau B, Chastang C, Leclerc P, Botto MJ, Sauvaget J. Superior vena cava syndrome in small-cell lung cancer. Arch Intern Med 1993; 153 (03) 384-387
    CrossrefPubMedGoogle Scholar
  • 9 Straka C, Ying J, Kong F-M, Willey CD, Kaminski J, Kim DW. Review of evolving etiologies, implications and treatment strategies for the superior vena cava syndrome. Springerplus 2016; 5 (01) 229
    CrossrefPubMedGoogle Scholar
  • 10 Kapur S, Paik E, Rezaei A, Vu DN. Where there is blood, there is a way: unusual collateral vessels in superior and inferior vena cava obstruction. Radiographics 2010; 30 (01) 67-78
    CrossrefPubMedGoogle Scholar
  • 11 Eren S, Karaman A, Okur A. The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT. Eur J Radiol 2006; 59 (01) 93-103
    CrossrefPubMedGoogle Scholar
  • 12 Yoshimitsu K, Honda H, Kuroiwa T. , et al. Unusual hemodynamics and pseudolesions of the noncirrhotic liver at CT. Radiographics 2001; 21 (Spec No): S81-S96
    CrossrefPubMedGoogle Scholar
  • 13 Virmani V, Lal A, Ahuja CK, Khandelwal N. The CT Quadrate lobe hot spot sign. Ann Hepatol 2010; 9 (03) 296-298
    PubMedGoogle Scholar
  • 14 Dickson AM. The focal hepatic hot spot sign. Radiology 2005; 237 (02) 647-648
    CrossrefPubMedGoogle Scholar
  • 15 Wan JF, Bezjak A. Superior vena cava syndrome. Emerg Med Clin North Am 2009; 27 (02) 243-255
    CrossrefPubMedGoogle Scholar
  • 16 Lepper PM, Ott SR, Hoppe H. , et al. Superior vena cava syndrome in thoracic malignancies. Respir Care 2011; 56 (05) 653-666
    CrossrefPubMedGoogle Scholar
  • 17 Lonardi F, Gioga G, Agus G, Coeli M, Campostrini F. Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly. Support Care Cancer 2002; 10 (02) 156-160
    CrossrefPubMedGoogle Scholar
  • 18 Rodrigues CI, Njo KH, Karim AB. Hypofractionated radiation therapy in the treatment of superior vena cava syndrome. Lung Cancer 1993; 10 (3-4): 221-228
    CrossrefPubMedGoogle Scholar
  • 19 Nicholson AA, Ettles DF, Arnold A, Greenstone M, Dyet JF. Treatment of malignant superior vena cava obstruction: metal stents or radiation therapy. J Vasc Interv Radiol 1997; 8 (05) 781-788
    CrossrefPubMedGoogle Scholar
  • 20 Wilson E, Lyn E, Lynn A, Khan S. Radiological stenting provides effective palliation in malignant central venous obstruction. Clin Oncol (R Coll Radiol) 2002; 14 (03) 228-232
    CrossrefPubMedGoogle Scholar
  • 21 Sato Y, Inaba Y, Yamaura H, Takaki H, Arai Y. Malignant inferior vena cava syndrome and congestive hepatic failure treated by venous stent placement. J Vasc Interv Radiol 2012; 23 (10) 1377-1380
    CrossrefPubMedGoogle Scholar
  • 22 Mose S, Stabik C, Eberlein K, Ramm U, Böttcher HD, Budischewski K. Retrospective analysis of the superior vena cava syndrome in irradiated cancer patients. Anticancer Res 2006; 26 (6C): 4933-4936
    PubMedGoogle Scholar
  • 23 Van Putten JW, Schlosser NJ, Vujaskovic Z, Leest AH, Groen HJ. Superior vena cava obstruction caused by radiation induced venous fibrosis. Thorax 2000; 55 (03) 245-246
    CrossrefPubMedGoogle Scholar
  • 24 Lanciego C, Pangua C, Chacón JI. , et al. Endovascular stenting as the first step in the overall management of malignant superior vena cava syndrome. AJR Am J Roentgenol 2009; 193 (02) 549-558
    CrossrefPubMedGoogle Scholar
  • 25 Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin Oncol (R Coll Radiol) 2002; 14 (05) 338-351
    CrossrefPubMedGoogle Scholar
  • 26 Lee-Elliott CE, Abubacker MZ, Lopez AJ. Fast-track management of malignant superior vena cava syndrome. Cardiovasc Intervent Radiol 2004; 27 (05) 470-473
    PubMedGoogle Scholar
  • 27 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 (01) 140-149
    CrossrefPubMedGoogle Scholar
  • 28 Ganeshan A, Hon LQ, Warakaulle DR, Morgan R, Uberoi R. Superior vena caval stenting for SVC obstruction: current status. Eur J Radiol 2009; 71 (02) 343-349
    CrossrefPubMedGoogle Scholar
  • 29 Büstgens FA, Loose R, Ficker JH, Wucherer M, Uder M, Adamus R. Stent implantation for superior vena cava syndrome of malignant cause. RoFo Fortschr Geb Rontgenstr Nuklearmed 2017; 189 (05) 423-430
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 30 Gwon DI, Ko GY, Kim JH, Shin JH, Yoon HK, Sung KB. Malignant superior vena cava syndrome: a comparative cohort study of treatment with covered stents versus uncovered stents. Radiology 2013; 266 (03) 979-987
    CrossrefPubMedGoogle Scholar
  • 31 Rachapalli V, Boucher LM. Superior vena cava syndrome: role of the interventionalist. Can Assoc Radiol J 2014; 65 (02) 168-176
    CrossrefPubMedGoogle Scholar
  • 32 Gray BH, Olin JW, Graor RA, Young JR, Bartholomew JR, Ruschhaupt WF. Safety and efficacy of thrombolytic therapy for superior vena cava syndrome. Chest 1991; 99 (01) 54-59
    CrossrefPubMedGoogle Scholar
  • 33 Uberoi R. Quality assurance guidelines for superior vena cava stenting in malignant disease. Cardiovasc Intervent Radiol 2006; 29 (03) 319-322
    CrossrefPubMedGoogle Scholar
  • 34 Dinkel HP, Mettke B, Schmid F, Baumgartner I, Triller J, Do DD. Endovascular treatment of malignant superior vena cava syndrome: is bilateral Wallstent placement superior to unilateral placement?. J Endovasc Ther 2003; 10 (04) 788-797
    CrossrefPubMedGoogle Scholar
  • 35 Choe YH, Im JG, Park JH, Han MC, Kim CW. The anatomy of the pericardial space: a study in cadavers and patients. AJR Am J Roentgenol 1987; 149 (04) 693-697
    CrossrefPubMedGoogle Scholar
  • 36 Nagata T, Makutani S, Uchida H. , et al. 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 2007; 30 (05) 959-967
    CrossrefPubMedGoogle Scholar
  • 37 Martin M, Baumgartner I, Kolb M, Triller J, Dinkel H-P. Fatal pericardial tamponade after Wallstent implantation for malignant superior vena cava syndrome. J Endovasc Ther 2002; 9 (05) 680-684
    CrossrefPubMedGoogle Scholar
  • 38 Entwisle KG, Watkinson AF, Reidy J. Case report: migration and shortening of a self-expanding metallic stent complicating the treatment of malignant superior vena cava stenosis. Clin Radiol 1996; 51 (08) 593-595
    CrossrefPubMedGoogle Scholar
  • 39 Fajardo LF, Lee A. Rupture of major vessels after radiation. Cancer 1975; 36 (03) 904-913
    CrossrefPubMedGoogle Scholar
  • 40 Zidar N, Ferluga D, Hvala A, Popović M, Šoba E. Contribution to the pathogenesis of radiation-induced injury to large arteries. J Laryngol Otol 1997; 111 (10) 988-990
    PubMedGoogle Scholar
  • 41 Cui J, Kawai T, Irani Z. Catheter-directed thrombolysis in acute superior vena cava syndrome caused by central venous catheters. Semin Dialysis 2015; 28 (05) 548-551
    CrossrefPubMedGoogle Scholar
  • 42 Abdullah BJ, Mohammad N, Sangkar JV. , et al. Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC). Br J Radiol 2005; 78 (931) 596-600
    CrossrefPubMedGoogle Scholar
  • 43 Clark K, Chick JF, Reddy SN. , et al. Concurrent central venous stent and central venous access device placement does not compromise stent patency or catheter function in patients with malignant central venous obstruction. J Vasc Interv Radiol 2017; 28 (04) 602-607
    CrossrefPubMedGoogle Scholar
  • 44 Kandpal H, Sharma R, Gamangatti S, Srivastava DN, Vashisht S. Imaging the inferior vena cava: a road less traveled. Radiographics 2008; 28 (03) 669-689
    CrossrefPubMedGoogle Scholar
  • 45 Kaufman LB, Yeh BM, Breiman RS, Joe BN, Qayyum A, Coakley FV. Inferior vena cava filling defects on CT and MRI. AJR Am J Roentgenol 2005; 185 (03) 717-726
    CrossrefPubMedGoogle Scholar
  • 46 Sauter A, Triller J, Schmidt F, Kickuth R. Treatment of superior vena cava (SVC) syndrome and inferior vena cava (IVC) thrombosis in a patient with colorectal cancer: combination of SVC stenting and IVC filter placement to palliate symptoms and pave the way for port implantation. Cardiovasc Intervent Radiol 2008; 31 (02) (Suppl. 02) S144-S148
    CrossrefPubMedGoogle Scholar
  • 47 Fletcher WS, Lakin PC, Pommier RF, Wilmarth T. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998; 133 (09) 935-938
    CrossrefPubMedGoogle Scholar
  • 48 Labropoulos N, Borge M, Pierce K, Pappas PJ. Criteria for defining significant central vein stenosis with duplex ultrasound. J Vasc Surg 2007; 46 (01) 101-107
    CrossrefPubMedGoogle Scholar
  • 49 Devcic Z, Techasith T, Banerjee A, Rosenberg JK, Sze DY. Technical and anatomic factors influencing the success of inferior vena caval stent placement for malignant obstruction. J Vasc Interv Radiol 2016; 27 (09) 1350-1360.e1
    CrossrefPubMedGoogle Scholar
  • 50 Jeong HJ, Seo IY, Rim JS. Chronic post-thrombotic obstruction of the inferior vena cava: both renal veins being the cause of painless gross hematuria from pelviureteral mucosal varices in normal functioning kidney. Yonsei Med J 2003; 44 (06) 1119-1121
    CrossrefPubMedGoogle Scholar
  • 51 Gordon S, Kerns T, Londeree W, Ching B. Idiopathic thrombosis of the inferior vena cava and bilateral femoral veins in an otherwise healthy male soldier. Case Rep Med 2013; 2013: 246201
    PubMedGoogle Scholar
  • 52 Shin N, Kim YH, Xu H. , et al. Redefining Budd-Chiari syndrome: a systematic review. World J Hepatol 2016; 8 (16) 691-702
    CrossrefPubMedGoogle Scholar
  • 53 Goto H, Hashimoto M, Akamatsu D. , et al. Surgical resection and inferior vena cava reconstruction for treatment of the malignant tumor: technical success and outcomes. Ann Vasc Dis 2014; 7 (02) 120-126
    CrossrefPubMedGoogle Scholar
  • 54 Quinones-Baldrich W, Alktaifi A, Eilber F, Eilber F. Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg 2012; 55 (05) 1386-1393 , discussion 1393
    CrossrefPubMedGoogle Scholar
  • 55 Brountzos EN, Binkert CA, Panagiotou IE, Petersen BD, Timmermans H, Lakin PC. Clinical outcome after intrahepatic venous stent placement for malignant inferior vena cava syndrome. Cardiovasc Intervent Radiol 2004; 27 (02) 129-136
    PubMedGoogle Scholar
  • 56 Razavi MK, Hansch EC, Kee ST, Sze DY, Semba CP, Dake MD. Chronically occluded inferior venae cavae: endovascular treatment. Radiology 2000; 214 (01) 133-138
    CrossrefPubMedGoogle Scholar
  • 57 Wallace MJ. Transatrial stent placement for treatment of inferior vena cava obstruction secondary to extension of intracardiac tumor thrombus from hepatocellular carcinoma. J Vasc Interv Radiol 2003; 14 (10) 1339-1343
    CrossrefPubMedGoogle Scholar
  • 58 Barquero-Romero J, López Cupido V, Torrado Sierra O, Valencia Terrón M. Severe ocular symptoms as an initial manifestation of superior vena cava syndrome [in Spanish]. Med Interna 2008; 25 (07) 356-358
    PubMedGoogle Scholar