Published in:
01-04-2013 | Imaging in Intensive Care Medicine
“Benign” superior vena cava syndrome
Published in: Intensive Care Medicine | Issue 4/2013
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A 41-year-old man, known to have congenital antithrombin (AT)-III deficiency, presented to the emergency department with progressive dyspnea, facial swelling, generalized edema, and hypotension. A viral gastroenteritis, several weeks before the admission, resulted in subtherapeutic international normalized ratio (INR) levels. Echocardiography showed inflow obstruction of the right ventricle with preserved left ventricular function. Computed tomography (CT) confirmed “benign” superior vena cava thrombosis with several collateral veins (Fig. 1). Endovascular stenting was carried out as a minimally invasive and simple procedure, restoring venous return with immediate relief of symptoms in our patient (Figs. 2, 3). Long-term anticoagulation was intensified, and he is currently doing well, 5 years after this complication of his AT-III deficiency.
Fig. 1
Coronal view of a chest CT scan showing the superior vena cava superior thrombosis (arrow)
Fig. 2
Angiography showing successful recanalization, stent placement, and angioplasty of the occluded superior vena cava
Fig. 3
Coronal view of a chest CT scan showing a patent superior vena cava after successful recanalization, stent placement, and angioplasty
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