Semin intervent Radiol 2007; 24(1): 082-086
DOI: 10.1055/s-2007-971198
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Acute Pericardial Effusion during Endovascular Intervention for Superior Vena Cava Syndrome: Case Series and Review

Susan K. O'Horo1 , Gregory M. Soares2 , Gregory J. Dubel2
  • 1Department of Radiology, Division of Interventional Radiology, Brigham and Women's Hospital, Boston, Massachusetts
  • 2Department of Radiology, Division of Interventional Radiology, Rhode Island Hospital, Providence, Rhode Island
Further Information

Publication History

Publication Date:
27 March 2007 (online)

ABSTRACT

We describe three cases of acute pericardial effusion during endovascular treatment of superior vena cava (SVC) syndrome, one of which resulted in fatal pericardial tamponade. SVC syndrome results from impaired venous return from the head and upper extremities to the right atrium. Malignancy and catheter-induced SVC stenosis accounts for the majority of cases of SVC syndrome. Endovascular therapy is the treatment of choice for SVC syndrome due to its rapid relief of symptoms and low morbidity. Acute pericardial effusion and pericardial tamponade may result from inadvertent extraluminal traversal of the SVC in the so-called danger zone above the right atrium, as well as secondary to dissection of wires in a location where fascial planes have been altered by neoplasia or inflammation.

REFERENCES

  • 1 Hennequin L M, Fade O, Bernadac P A et al.. Superior vena cava stent placement: results with the Wallstent endoprosthesis.  Radiology. 1995;  196 353-361
  • 2 Hochrein J, Bashore T M, O'Laughlin M P, Harrison J K. Percutaneous stenting of superior vena cava syndrome: a case report and review of the literature.  Am J Med. 1998;  104 78-84
  • 3 Kee S T, Kinoshita L, Razavi M K, Nyman U R, Semba C P, Dake M D. Superior vena cava syndrome: treatment with catheter directed thrombolysis and endovascular stent placement.  Radiology. 1998;  206 187-193
  • 4 Sharafuddin M J, Sun S, Hoballah J J. Endovascular management of venous thromboembolic diseases of the upper torso and extremities.  J Vasc Interv Radiol. 2002;  13 975-990
  • 5 Kalra M, Gloviczki P, Andrews J C et al.. Open surgical and endovascular treatment of superior vena cava syndrome caused by nonmalignant disease.  J Vasc Surg. 2003;  38 215-223
  • 6 Lanciego C, Chacon J L, Julian A et al.. Stenting as first option for endovascular treatment of malignant superior vena cava syndrome.  AJR Am J Roentgenol. 2001;  177 585-593
  • 7 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;  9 680-684
  • 8 Boardman P, Ettles D F. Cardiac tamponade: a rare complication of attempted stenting in malignant superior vena caval obstruction.  Clin Radiol. 2000;  55 645-647
  • 9 Forauer A R, Dasika N L, Gemmete J J, Theoharis C. Pericardial tamponade complicating central venous intervention.  J Vasc Interv Radiol. 2003;  14 255-259
  • 10 Brown K T, Getrajdman G I. Balloon dilation of the superior vena cava (SVC) resulting in SVC rupture and pericardial tamponade: a case report and brief review.  Cardiovasc Intervent Radiol. 2005;  28 372-376
  • 11 Hollingshead W H. Textbook of Anatomy. 4th ed. Hagerstown, MD; Lippincott Williams and Wilkins 1985
  • 12 Langman J. Atlas of Medical Anatomy. St. Louis, MO; WB Saunders Co 1978

Susan K O'HoroM.D. M.P.H. 

Instructor, Department of Radiology, Division of Interventional Radiology

Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115