Superior Vena Cava Bypass with Superficial Femoral Vein for Benign Superior Vena Cava Syndrome

Superior vena cava (SVC) syndrome can result from benign causes such as temporary hemodialysis catheters placed into the central veins. The indications for open, surgical revascularization are rare and usually reserved for patients whose symptoms are refractory to anticoagulation and endovascular treatment. The current report documents the case of a 54-year-old woman with recurrent SVC syndrome secondary to long-term indwelling central venous catheters for total parenteral nutrition. She presented to the vascular service with moderate head/neck edema and persistent headaches despite chronic anticoagulation and multiple previous endovascular attempts including both angioplasty and stenting. An internal jugular-SVC bypass was performed using autogenous superficial femoral vein (SFV), which resulted in the resolution of her symptoms and a patent graft 12 months postoperatively. Autogenous SFV is an ideal conduit for central vein revascularization secondary to its size, relative ease associated with harvesting, and handling characteristics. It may be the ideal conduit for revascularization in patients with SVC syndrome secondary to benign causes because of their favorable life expectancy, although documentation of long-term graft patency is necessary.