CASE REPORTS  THORACIC SECTION 

The Journal of Cardiovascular Surgery 2002 April;43(2):287-90

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Severe obstruction of the superior vena cava caused by tumor invasion. Recanalization using a PTFE-covered Z stent

Dendo S., Inaba Y., Arai Y., Matsueda K., Aramaki T., Tanaka T., Furutani K., Fuwa N.

From the Department of Diagnostic Radiology *Department of Radiation Oncology Aichi Cancer Center, Chikusa-ku, Nagoya, Japan

Bare ­stents are com­monly ­used for the treat­ment of malig­nant ­vena ­cava ste­noses. How­ever, the ther­a­peutic ­effect of treat­ment ­using ­bare ­stents for ­cases ­with intra­lu­minal ­tumor inva­sion is not sat­is­fac­tory. We ­report a ­case ­with ­severe obstruc­tion of the ­superior ­vena ­cava ­caused by ­tumor inva­sion of med­i­as­tinal ­lymph ­node metas­tases ­from ­colon ­cancer, ­which was suc­cess­fully ­treated by the rec­a­nal­iza­tion of ­superior ­vena ­cava ­using a poly­tet­ra­flu­o­roe­thy­lene-cov­ered Z ­stent. The cov­ered ­stent ­could not be ­fully ­expanded at ­first, and re-obstruc­tion devel­oped at the ­stented ­site due to ­thrombus for­ma­tion ­soon ­after ­stenting. So, the addi­tional bal­loon dil­a­ta­tion ­made the ­stent ­expend ­fully on ­another day of ­stenting. ­After the bal­loon dil­a­ta­tion ­blood ­flow ­improved imme­di­ately and the clin­ical symp­toms asso­ciated ­with the ­superior ­vena ­cava obstruc­tion ­resolved. There­after no symp­to­matic recur­rence has ­been ­observed in 12 ­months of ­follow-up ­period.