Large-bore nitinol stents for malignant superior vena cava syndrome: factors influencing outcome.
AJR Am J Roentgenol
; 201(3): 667-74, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23971462
ABSTRACT
OBJECTIVE:
The purpose of this article is to retrospectively evaluate the technical and clinical outcomes of large-bore nitinol stents for treating malignant superior vena cava syndrome. In addition, we analyzed factors potentially influencing the outcome. MATERIALS ANDMETHODS:
Over a 7-year period, 78 consecutive patients presented with superior vena cava syndrome related to primary lung tumor (n=62) or malignant lymphadenopathies (n=16). The factors analyzed were Kishi score at admission, tumor type, and need for an additional balloon-expandable stent.RESULTS:
Technical success was obtained in all but one patient (99%), who presented with a stent migration immediately after insertion. In 17 patients (22%), an additional balloon-expandable stent was needed for complete expansion of the nitinol stent. For patients with symptomatic malignant lymphadenopathies or primary lung tumor, overall survival rates were 50% (n=8) and 54% (n=34), respectively, at 6 months and 19% (n=3) and 34% (n=21), respectively, at 12 months (p=0.376). There was no difference in survival as a function of the Kishi score (p=0.80) or of the placement of an additional balloon-expandable stent (p=0.35). Finally, reocclusion events were noted in patients both with (n=1) and without (n=7) a balloon-expandable stent.CONCLUSION:
Large-bore nitinol stents are highly effective for malignant superior vena cava syndrome. The survival rates of patients with caval vein stenosis due to either the primary tumor or secondary enlarged adenopathies were equal. An additional balloon-expandable stent was required in 22% of cases owing to incomplete expansion of the nitinol stent but was not associated with higher thrombosis rate.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome da Veia Cava Superior
/
Stents
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
AJR Am J Roentgenol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Bélgica