PURPOSE Venous congestion of the superior or inferior caval system has to be considered as a medical emergency. The results of various recanalization procedures and their utility are analyzed. PATIENTS AND METHODS 176 patients with superior and 28 with inferior caval obstruction were treated with Gianturco-Z (n = 39) and Wall Stents (n = 207) respectively. Balloon venoplasty was performed prior to stent implanation. In 27 cases, local thrombolysis with urokinase was employed. RESULTS Interventional procedures were successful in 198 and without success in 6 patients. In most patients, symptoms were relieved during or early after recanalization. No major complications were found. DISCUSSION Balloon angioplasty with stent placement and local thrombolysis are successful in the treatment of superior and inferior caval obstruction. Self-expanding Wallstents are superior to Gianturco-Z-stents. Oncologists should be made familiar with this type of treatment.

[Interventional radiology in central venous obstructions. Dilatation--stent implantation--thrombolysis].

A 4-year-old female with hypoplastic left heart syndrome and Fontan palliation presented with severe neurologic impairment from thrombosis of the superior vena cava (SVC). She underwent successful SVC thrombectomy with the X-SIZER® Thrombectomy Catheter System, followed by balloon angioplasty. She demonstrated rapid improvement in her neurologic deficits after the procedure. This represents the first published use of the X-SIZER in a child and its first published use for SVC thrombectomy. © 2006 Wiley-Liss, Inc.

/pdf/superior-vena-cava-thrombectomy-with-the-x-sizer-catheter-3xlcrelo39.pdf

Superior vena cava thrombectomy with the X-SIZER catheter system in a child with Fontan palliation.

The superior vena cava obstruction is a relatively rare condition. We report the case of a 42 year old man suffering of hypertension for about fifteen years. He reported a cervical and thoracic pain for one year, that was related to a 95% of occlusion on the right coronary artery. An angioplasty has been done but the patient still related the thoracic pain. Afterwards the patient had recurrent episodes of right hemiplegia and hypertensive emergencies that have been treated with anti-hypertensive agents. A venous disease was suspected because of cyanosis in the face especially when episodes of transient ischemic attacks occurred. A venography showed obstruction of the right jugular vein near the junction with the superior vena cava. In conclusion, it was not possible to define with certainty the relationship between the two pathologies presented by the patient, even so, we call attention to the improvement of the neurological symptoms after the control of superior vena cava obstruction with the treatment.

Ataques isquêmicos transitórios em paciente com síndrome da veia cava superior

Case Reports Superior Vena Cava Thrombectomy with the X-SIZER 1 Catheter System in a Child with Fontan Palliation

/pdf/transient-ischemic-attacks-in-a-patient-with-superior-vena-57n2r85llz.pdf

[Transient ischemic attacks in a patient with superior vena cava obstruction: case report].

We report a patient with repeated venous infarcts in the occipital lobe and occlusion of the superior vena cava. The pathogenetic relationships between the superior vena cava occlusion and the brain infarcts are discussed. High pressure in the superior venous territory and incomplete patency of the transverse sinus are probably responsible for the venous infarcts.

Recurrent cerebral venous infarcts and superior vena cava obstruction: case report.

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Recurrent cerebral venous infarcts and superior vena cava obstruction: case report.