Successful Treatment of Superior Vena Cava Rupture with Placement of a Covered Stent: A Report of Two Cases

Excerpt

Superior vena cava syndrome (SVCS) is characterized by the development of symptoms, including facial, head, neck, chest, and upper extremity swelling, shortness of breath, and headache, in the setting of superior vena cava (SVC) stenosis or occlusion [1, 2]. SCVS may be caused by a variety of benign and malignant conditions. Since the development of self- and balloon-expandable stents, endovascular repair has become the first-line therapy for the treatment of SVCS [3‐5]. The most common complications of stent placement include pulmonary embolus (PE), stent migration, fracture, and misplacement [6]. There are a few case reports describing subclinical rupture after stent placement and death secondary to cardiac tamponade from balloon dilatation of the SVC [7, 8]. Additionally, there is one case report describing the placement of a covered stent for superior vena cava rupture (SVCR) in a non-peer-reviewed journal [9]. We present two cases of SVCR during SVC balloon angioplasty and bare metal stent placement that were successfully treated with placement of a covered stent. Placement of a covered stent may provide a rapid definitive treatment to prevent death from SVCR. …