1
|
Abbas A, Almarzooqi N, Harhara T. First presentation of Graves' thyroid storm complicated by catastrophic antiphospholipid antibody syndrome: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241252809. [PMID: 38737564 PMCID: PMC11088809 DOI: 10.1177/2050313x241252809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Catastrophic antiphospholipid antibody syndrome is a rare and severe subtype of antiphospholipid syndrome with multisystemic organ failure due to thromboembolic events, resulting in high mortality rates. The association between catastrophic antiphospholipid antibody syndrome and autoimmune thyroid diseases is rarely reported in the literature. We report a case of a 35-year-old previously healthy female with Graves' thyroid storm, positive lupus antibodies, and probable catastrophic antiphospholipid antibody syndrome. Her hospital course was complicated by extensive venous thromboembolism, superior vena cava syndrome, thromboembolic strokes, and Takotsubo cardiomyopathy. Eventually, this led to an unfortunate death secondary to profound shock after 8 days despite emergent treatment. Our case report discusses the link between autoimmune thyroid disorders and catastrophic antiphospholipid antibody syndrome. We emphasize the difficulty in diagnosing catastrophic antiphospholipid antibody syndrome in extremely ill patients and stress the significance of considering it as a possible cause in thyrotoxicosis patients with multiple organ failure and hypercoagulability. Early recognition and prompt management are crucial in improving outcomes in these patients.
Collapse
Affiliation(s)
- Aymen Abbas
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Noura Almarzooqi
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Thana Harhara
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| |
Collapse
|
2
|
Pennetta FF, Millarelli M, De Santis F, Bandiera A, Tozzi M, Chiappa R. Cavoatrial junction stenting in vascular hemodialysis catheter malfunction. J Vasc Access 2024:11297298241250372. [PMID: 38708829 DOI: 10.1177/11297298241250372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
In patients undergoing hemodialytic treatment via intravascular catheters, stenosis or occlusion of central veins is common. Despite an extensive characterization of Superior Vena Cava Syndrome (SVCS) no data is available about CavoAtrial Junction (CAJ) stenosis. We report the case of two patients with a story of multiple catheter failures due to thrombosis or infection. Computed tomography (CT) showed radiological signs of CAJ stenosis confirmed at the following venography. In absence of other feasible options to place a vascular access, the two underwent stenting with Gore Viabahn VBX balloon expandable endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ, USA) of the CAJ stenosis. Completion venography showed complete resolution of the stenosis in both patients. No complications occurred during the procedures. At a mean follow-up of 878 ± 559 days no signs of in-stent restenosis or recoil were found. The present cases emphasize the feasibility and safety of CAJ stenting, underlining the importance of preserving CAJ and upper veins patency in hemodialysis access.
Collapse
Affiliation(s)
| | | | | | | | - Matteo Tozzi
- Vascular Surgery Unit, University of Insubria, Varese, Lombardy, Italy
| | | |
Collapse
|
3
|
Ostroff M, Elzomor H, Weite TA, Garcia D, Ahn J, Stanko O, Anderson K, Winborne A, Alexandrou E. Femoral to abdomen tunneling at the bedside for medium/long term venous access. J Vasc Access 2024:11297298241251510. [PMID: 38708830 DOI: 10.1177/11297298241251510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Femoral to abdomen tunneling of small-bore central venous catheters is a bedside technique for patients with contraindications to a thoracic approach, or as an alternative to a lower extremity catheter exit site. METHOD A femoral to abdomen tunneling technique was implemented for patients receiving medium and long-term intravenous treatments with contraindications to the thoracic venous approach or as an alternative to a lower extremity catheter exit site. All venous access devices were inserted with ultrasound guidance under local anesthesia, and catheter tip placement assessed by post procedural radiography. RESULTS In this case series, from January 2020 to January 2023, a total of eight FTA-tunneled venous access devices were inserted. There were seven ambulatory patients and one bedbound patient. The median length of the subcutaneous tunnel was 20 cm, ranging from 15 to 27 cm. The median length of the intravenous catheter to the terminal tip was 31 cm, ranging from 23 to 40 cm. Tip location was confirmed by post-procedural abdominal radiograph. The catheter tip locations were interpreted to be at the level of T8-T9 (2), T12 (1), L4 (2), L2 (2), L1(1).No insertion or post insertion related complication was reported. Six patients completed the scheduled intravenous treatment. One patient was unable to be tracked due to transfer to an outside facility. One catheter initially demonstrated to be coiled over the left common iliac vessel was repositioned using a high flow flush technique. There was one reported catheter dislodgment by the nurse providing care and maintenance. The overall implant days were 961, with a median dwell time of 125 days ranging from 20 to 399 days. CONCLUSION Femoral to abdomen tunneling provides an alternative exit site useful in select patients with complex intravenous access. The data of this small retrospective review suggests this a safe and minimally invasive bedside procedure.
Collapse
Affiliation(s)
- Matt Ostroff
- Saint Josephs Regional Medical Center, Paterson, NJ, USA
| | | | | | - Daniel Garcia
- Saint Josephs Regional Medical Center, Paterson, NJ, USA
| | - Jane Ahn
- Saint Josephs Regional Medical Center, Paterson, NJ, USA
| | - Olena Stanko
- Saint Josephs Regional Medical Center, Paterson, NJ, USA
| | | | | | | |
Collapse
|
4
|
An TJ, McNamara SL, Ardestani A, Zurkiya O, Cahalane A, Stecker MS, Epelboym Y, Burch E, Desai K, Kalva SP. Safety and Effectiveness of Abre Self-Expanding Venous Stent for Treatment of Superior Vena Cava Syndrome. Vasc Endovascular Surg 2024:15385744241251638. [PMID: 38670555 DOI: 10.1177/15385744241251638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
PURPOSE Superior vena cava (SVC) syndrome is a constellation of symptoms that results from partial or complete SVC obstruction. Endovascular SVC stenting is an effective treatment for SVC syndrome with rapid clinical efficacy and low risk of complications. In this study, we assess the technical and clinical outcomes of a cohort of patients with SVC syndrome treated with the AbreTM self-expanding venous stent (Medtronic, Inc, Minneapolis, MN, USA). METHODS An institutional database was used to retrospectively identify patients with SVC syndrome treated with AbreTM venous self-expanding stent placement between 2021-2023. Patient demographic data, technical outcomes, treatment effectiveness, and adverse events were obtained from the electronic medical record. Nineteen patients (mean age 58.6) were included in the study. Thirteen interventions were performed for malignant compression of the SVC, 5 for central venous catheter-related SVC stenosis, and 1 for HD fistula-related SVC stenosis refractory to angioplasty. RESULTS Primary patency was achieved in 93% of patients (17/19). Two patients (7%) required re-intervention with thrombolysis and angioplasty within 30 days post-stenting. Mean duration of clinical and imaging follow-up were 228.7 ± 52.7 and 258.7 ± 62.1 days, respectively. All patients with clinical follow-up experienced significant improvement in clinical symptoms post-intervention. No stent related complications were identified post-intervention. CONCLUSIONS Treatment of SVC syndrome with the AbreTM self-expanding venous stent has high rates of technical and clinical success. No complications related to stent placement were identified in this study.
Collapse
Affiliation(s)
- Thomas J An
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L McNamara
- Harvard-MIT Health Sciences and Technology, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ali Ardestani
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Omar Zurkiya
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Alexis Cahalane
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Michael S Stecker
- Division of Angiography and Interventional Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Yan Epelboym
- Division of Angiography and Interventional Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Ezra Burch
- Division of Angiography and Interventional Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Khanant Desai
- Division of Angiography and Interventional Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Sanjeeva P Kalva
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
5
|
Velasco-Amador JP, Prados-Carmona Á, Navarro-Triviño FJ. If not angioedema, what is it? Diagnostic approach to facial edema. J Dtsch Dermatol Ges 2024; 22:501-512. [PMID: 38483055 DOI: 10.1111/ddg.15336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/16/2023] [Indexed: 04/05/2024]
Abstract
Facial edema is a relatively frequent clinical presentation encountered in patients seen in allergology and dermatology clinics. The differential diagnosis is broad, and sometimes the definitive diagnosis can be a challenge for the clinician. Facial angioedema itself encompasses different etiopathologies (histaminergic, bradykinergic, etc.) that must be distinguished from other causes of facial edema, such as allergic contact dermatitis, granulomatous conditions, inflammatory causes, infections, neoplasms or paraneoplastic syndromes, autoimmune diseases, among other entities hereby referred as miscellanea. A proper diagnostic approach is essential to order the appropriate tests, as well as to prescribe a targeted treatment. This review focuses on entities that present with facial edema and summarize their characteristic clinical features.
Collapse
Affiliation(s)
| | | | - Francisco José Navarro-Triviño
- Departamento de Eczema de Contacto e Inmunoalergia, Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario San Cecilio, Granada, Spain
| |
Collapse
|
6
|
Yan A, Ford KS, Faloye AO. Superior Vena Cava Rupture Complicated by Cardiac Tamponade. J Cardiothorac Vasc Anesth 2024; 38:788-791. [PMID: 38184382 DOI: 10.1053/j.jvca.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Amy Yan
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Emory University, Atlanta, GA
| | - Korrin Scott Ford
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Emory University, Atlanta, GA
| | - Abimbola O Faloye
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Emory University, Atlanta, GA.
| |
Collapse
|
7
|
Monden Y, Une D, Torigoe H, Isoda T, Kamaguchi S, Yoshida K, Hirami Y, Nakai M. Surgical resection of an intraluminal tumor in the azygos vein with an unknown primary site causing superior vena cava syndrome. Thorac Cancer 2024; 15:578-581. [PMID: 38316628 PMCID: PMC10912538 DOI: 10.1111/1759-7714.15233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Intraluminal tumor in the azygos vein is a rare disease that can cause superior vena cava (SVC) syndrome. Radiotherapy and endovascular stenting with or without chemotherapy are reported to have a high clinical success rate for the management of SVC syndrome with malignancy, but a poor survival rate. Here, we report a 69-year-old man who presented with swelling of the face and upper extremities, who was diagnosed with SVC syndrome caused by an intraluminal tumor in the azygos vein. Enhanced chest computed tomography revealed an intraluminal mass with a filling defect from the azygos vein to the SVC, with no extravascular extension or dissemination of the primary tumor. Surgical resection of the mass en bloc with the azygos vein and SVC reconstruction was performed. A poorly differentiated carcinoma was diagnosed on postoperative pathological evaluation. Twelve months after resection, the patient was well with no signs of recurrent disease. This case highlights that surgical resection should be considered as a treatment of choice for the management of SVC syndrome caused by an intraluminal malignancy in the azygos vein.
Collapse
Affiliation(s)
- Yuki Monden
- Department of Cardiovascular SurgeryOkayama Medical CenterOkayamaJapan
| | - Dai Une
- Department of Cardiovascular SurgeryOkayama Medical CenterOkayamaJapan
| | - Hidejiro Torigoe
- Department of Thoracic SurgeryOkayama Medical CenterOkayamaJapan
| | - Tetsuya Isoda
- Department of PathologyOkayama Medical CenterOkayamaJapan
| | - Suzuka Kamaguchi
- Department of Cardiovascular SurgeryOkayama Medical CenterOkayamaJapan
| | - Kenji Yoshida
- Department of Cardiovascular SurgeryOkayama Medical CenterOkayamaJapan
| | - Yuji Hirami
- Department of Thoracic SurgeryOkayama Medical CenterOkayamaJapan
| | - Mikizo Nakai
- Department of Cardiovascular SurgeryOkayama Medical CenterOkayamaJapan
| |
Collapse
|
8
|
D'Amico R, Nicoli A, Zdoroveac A, Gürke L, Isaak A. Vascular access challenges in hemodialysis patients with superior vena cava syndrome. J Vasc Access 2024:11297298241227549. [PMID: 38316621 DOI: 10.1177/11297298241227549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Superior vena cava syndrome in hemodialysis patients resulting from previous or current use of a tunneled central vein catheter is a rare but potentially severe condition. Two aspects have to be addressed during management and treatment: the restoration of central venous flow and the creation of an alternative vascular access to guarantee hemodialysis. RESEARCH DESIGN Conforming to the current guidelines and literature, we present a stepwise approach and discuss therapeutic options. The removal of the tunneled central vein catheter should be attempted and a native vascular access created whenever feasible. RESULTS First, an upper extremity AVF should be preserved or, as in our case, made functional. Endovascular treatment of CVSO should primarily consist of balloon dilatation. Placement of a stent or stent graft should be considered as a secondary option. HeRO graft placement may be considered in recurrent CVSO and recanalization with a Surfacer. LL-AVF or AVG need to be discussed and may be an alternative for certain HD patients when the risk of lower limb ischemia and infection is considered. CONCLUSION Several therapeutic options are available and the basic principles are well established in the literature, although the level of evidence is not high. Therefore, we propose a stepwise and interdisciplinary approach to guide the challenging decision-making process in SVC.
Collapse
Affiliation(s)
- Rosalinda D'Amico
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Andrew Nicoli
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Andrei Zdoroveac
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Lorenz Gürke
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
- Vascular and Endovascular Surgery, University Hospital Basel, Basel, Basel-Stadt, Switzerland
| | - Andrej Isaak
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
- Vascular and Endovascular Surgery, University Hospital Basel, Basel, Basel-Stadt, Switzerland
| |
Collapse
|
9
|
Gemnani R, Saboo K, Patil R, Kumar S, Acharya S. T-cell Lymphoblastic Lymphoma Unveiling As Superior Vena Cava Syndrome in a 19-Year-Old Male. Cureus 2024; 16:e54729. [PMID: 38524018 PMCID: PMC10961148 DOI: 10.7759/cureus.54729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Superior vena cava syndrome (SVCS) is a collection of signs and symptoms resulting from superior vena cava obstruction which is either partial or complete. SVCS is a rare clinical entity, often associated with various malignancies. T-cell lymphoblastic lymphoma (T-LBL) primarily of the mediastinum (thymus) is a rare and aggressive non-Hodgkin lymphoma that can lead to SVCS. We discuss the case of a 19-year-old male who arrived at our emergency department with symptoms of cough, breathlessness, and facial puffiness along with swelling in the right anterior mediastinum for two weeks suggestive of acute SVCS. An anterior mediastinal mass was confirmed on a chest X-ray and computed tomography. A biopsy of the mass revealed primary mediastinal (thymic) T-LBL. This case report focuses on the unique presentation of a T-LBL as SVCS in a 19-year-old male. Moreover, it highlights the need for vigilance among healthcare providers in recognizing this atypical complication and underscores the critical importance of early diagnosis and timely intervention.
Collapse
Affiliation(s)
- Rinkle Gemnani
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Keyur Saboo
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Rajvardhan Patil
- Department of Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| |
Collapse
|
10
|
Iwakawa H, Suzuki T, Terata K, Watanabe H. Successful treatment of lead-related superior vena cava syndrome in combination with transvenous lead extraction and venous stenting. J Arrhythm 2023; 39:813-815. [PMID: 37799792 PMCID: PMC10549838 DOI: 10.1002/joa3.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 10/07/2023] Open
Abstract
We experienced a case of lead-related SVC syndrome, which was successfully treated using unique transvenous lead extraction technique and endovascular stenting. This case also suggests that intravascular ultrasound facilitates decision-making on whether the interventionist should perform TLE alone or add stenting in case of a lead-related venous obstruction.
Collapse
Affiliation(s)
- Hidehiro Iwakawa
- Department of Cardiovascular MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Tomohito Suzuki
- Department of Cardiovascular MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Ken Terata
- Department of Cardiovascular MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Hiroyuki Watanabe
- Department of Cardiovascular MedicineAkita University Graduate School of MedicineAkitaJapan
| |
Collapse
|
11
|
Kassab J, Gebrael G, Chedid El Helou M, El Dahdah J, Haroun E, Kassab R, Abou Ali S, Khabbaz Z, Kassab R. Case report: Primary cardiac lymphoma manifesting as superior vena cava syndrome. Front Cardiovasc Med 2023; 10:1257734. [PMID: 37808889 PMCID: PMC10556236 DOI: 10.3389/fcvm.2023.1257734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
A 64-year-old man presented with symptoms indicative of superior vena cava syndrome. Imaging work-up revealed an obstructing right atrial mass, which was subsequently excised and diagnosed as primary cardiac lymphoma. Post-surgery, the patient showed significant clinical improvement and was started on a chemotherapy regimen with complete remission at 1 year.
Collapse
Affiliation(s)
- Joseph Kassab
- Cleveland Clinic Foundation, Heart Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Georges Gebrael
- Department of Medicine, Saint Joseph University of Beirut, Achrafieh, Beirut, Lebanon
| | - Michel Chedid El Helou
- Cleveland Clinic Foundation, Heart Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Joseph El Dahdah
- Cleveland Clinic Foundation, Heart Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Elio Haroun
- Cleveland Clinic Foundation, Heart Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Rebecca Kassab
- Department of Medicine, Saint Joseph University of Beirut, Achrafieh, Beirut, Lebanon
| | - Saad Abou Ali
- Department of Cardiovascular Medicine, Sacre Coeur Hospital, Baabda, Beirut, Lebanon
| | - Ziad Khabbaz
- Department of Cardiovascular Medicine, Hotel-Dieu De France, Achrafieh, Beirut, Lebanon
| | - Roland Kassab
- Department of Cardiovascular Medicine, Hotel-Dieu De France, Achrafieh, Beirut, Lebanon
| |
Collapse
|
12
|
Formicola AM, Sunkara N, Santos MA. A Breathtaking Scenario: Superior Vena Cava Syndrome. R I Med J (2013) 2023; 106:18-21. [PMID: 37643336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
| | | | - Michael A Santos
- The Warren Alpert Medical School of Brown University; The Miriam Hospital, Providence, RI
| |
Collapse
|
13
|
Liu YM, Wei YJ, Lu XQ, Wang YF, Wang P, Liang XH. Catheter-related superior vena cava obstruction: A rare cause of chylothorax in maintenance hemodialysis patients. J Vasc Access 2023; 24:1207-1212. [PMID: 35090360 DOI: 10.1177/11297298211073425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
With the extensive use of dialysis catheters in patients undergoing hemodialysis, superior vena cava (SVC) syndrome has gradually attracted attention in recent years. Chylothorax caused by SVC syndrome is rarely reported. In this paper, we report a case of chylothorax secondary to superior vena cava obstruction (SVCO) in a maintenance hemodialysis patient after multiple dialysis catheter placements. Relieving the SVCO through intravascular intervention could effectively treat chylothorax. In the past fourteen months, no recurrence of symptoms has been observed.
Collapse
Affiliation(s)
- Ya-Min Liu
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu-Juan Wei
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao-Qing Lu
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu-Fei Wang
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pei Wang
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
| | - Xian-Hui Liang
- Blood Purification Center, Institute of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
14
|
Shah RP, Bolaji O, Duhan S, Ariaga AC, Keisham B, Paul T, Aljaroudi W, Alraies MC. Superior Vena Cava Syndrome: An Umbrella Review. Cureus 2023; 15:e42227. [PMID: 37605686 PMCID: PMC10439982 DOI: 10.7759/cureus.42227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Superior vena cava syndrome (SVCS) is a medical emergency that encompasses an array of signs and symptoms due to obstruction of blood flow through the superior vena cava (SVC). It poses a significant healthcare burden due to its associated morbidity and mortality. Its impact on the healthcare system continues to grow due to the increasing incidence of the condition. This incidence trend has been attributed to the growing use of catheters, pacemakers, and defibrillators, although it is a rare complication of these devices. The most common cause of SVCS remains malignancies accounting for up to 60% of the cases. Understanding the pathophysiology of SVCS requires understanding the anatomy, the SVC drains blood from the right and left brachiocephalic veins, which drain the head and the upper extremities accounting for about one-third of the venous blood to the heart. The most common presenting symptoms of SVCS are swelling of the face and hand, chest pain, respiratory symptoms (dyspnea, stridor, cough, hoarseness, and dysphagia), and neurologic manifestations (headaches, confusion, or visual/auditory disturbances). Symptoms generally worsen in a supine position. Diagnosis typically requires imaging, and SVCS can be graded based on classification schemas depending on the severity of symptoms and the location, understanding, and degree of obstruction. Over the past decades, the management modalities of SVCS have evolved to meet the increasing burden of the condition. Here, we present an umbrella review providing an overall assessment of the available information on SVCS, including the various management options, their indications, and a comparison of the advantages and disadvantages of these modalities.
Collapse
Affiliation(s)
- Rajendra P Shah
- Department of Internal Medicine, Vassar Brothers Medical Center, Poughkeepsie, USA
| | - Olayiwola Bolaji
- Department of Internal Medicine, University of Maryland Capital Regional Medical Center, Largo, USA
| | - Sanchit Duhan
- Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, USA
| | - Anderson C Ariaga
- Department of Internal Medicine, Vassar Brothers Medical Center, Poughkeepsie, USA
| | - Bijeta Keisham
- Sinai Center for Thrombosis and Research, Sinai Hospital of Baltimore, Baltimore, USA
| | - Timir Paul
- Section of Interventional Cardiology, University of Tennessee at Nashville/Ascension Saint Thomas Hospital, Nashville, USA
| | - Wael Aljaroudi
- Department of Cardiology, Augusta University Medical College of Georgia, Augusta, USA
| | - M Chadi Alraies
- Department of Cardiology, Detroit Medical Center, Detroit, USA
| |
Collapse
|
15
|
Mora A, Ghavamrezaii A, Abidali H, Caballero H, Hamidullah A, Mitzov N. Mediastinal Bronchogenic Cyst With Superior Vena Cava Syndrome: A Case Report. Cureus 2023; 15:e42040. [PMID: 37593276 PMCID: PMC10431947 DOI: 10.7759/cureus.42040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Bronchogenic cysts are rare in adults and often remain undetected until discovered incidentally on imaging or during a symptomatic investigation. The possibility of superior vena cava (SVC) compression due to a bronchogenic cyst arises in complex patient presentations. SVC syndrome poses several unique challenges due to the wide range of clinical symptoms and difficulty identifying the cause when symptoms first manifest. This case report examines a 39-year-old male who presented with symptoms resulting from SVC compression caused by a bronchogenic cyst, leading to SVC syndrome. We discuss the various imaging modalities used to assess the severity of the obstruction and the surgical interventions employed to alleviate the symptoms. A surgical intervention provides symptomatic relief and promises an excellent prognosis when performed without complications.
Collapse
Affiliation(s)
- Annalee Mora
- Internal Medicine, Oak Hill Hospital, Brooksville, USA
| | | | | | | | | | | |
Collapse
|
16
|
Ascione A, Martino G, Di Donato F, Casini B, Covello R, Ascani S. CIC-rearranged sarcoma presenting with superior vena cava syndrome: case report. Pathologica 2023; 115:97-100. [PMID: 37114626 PMCID: PMC10462994 DOI: 10.32074/1591-951x-784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/10/2022] [Indexed: 04/29/2023] Open
Abstract
CIC-rearranged sarcomas are rare mesenchymal neoplasms belonging to the family of undifferentiated small round cell sarcomas. This report details the case of a 45-year-old man presenting with symptoms of mediastinal compression, radiological diagnosis of a mediastinal mass and rapid evolution to full-blown superior vena cava syndrome. The emergency was successfully managed with a pharmacological approach. Formulation of a pathological diagnosis of CIC-rearranged sarcoma was initially supported by fluorescence in situ hybridisation findings and later validated by next-generation sequencing, which showed CIC-DUX4 gene fusion. A chemotherapy regimen was started with immediate benefits for the patient. The spectrum of pathological entities able to cause superior vena cava syndrome is wide, and recognition of rare causes is important to tailor the therapeutic approach to the specific disease. This is, to the best of our knowledge, the first report of CIC-rearranged sarcoma presenting with superior vena cava syndrome.
Collapse
Affiliation(s)
- Andrea Ascione
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera “Santa Maria” di Terni, Terni, Italy
| | | | - Beatrice Casini
- Department of Research, Diagnosis and Innovative Technology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera “Santa Maria” di Terni, Terni, Italy
| |
Collapse
|
17
|
Shwe T, Javed A, Patel R, Akhrass P. Recurrent Transient Ischemic Attacks in a Patient with Multiple Pacemaker Leads. J Innov Card Rhythm Manag 2023; 14:5424-5430. [PMID: 37143573 PMCID: PMC10153006 DOI: 10.19102/icrm.2023.14042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/26/2022] [Indexed: 05/06/2023] Open
Abstract
Venous complications-specifically, stenosis and thrombosis-are both well-known complications of transvenous implantation of pacemakers and defibrillators. Although they are a well-recognized phenomenon, these complications are rarely of clinical significance. One of the most concerning complications is the development of superior vena cava (SVC) syndrome. Studies have found that the incidence of SVC syndrome varies from 1 in 3,100 to 1 in 650 patients. The azygos-hemiazygos venous system is the most commonly observed collateral. We report a case of a 71-year-old female patient who presented with stroke-like symptoms during the injection of agitated saline bubbles while performing an echo and was found to have an unusual venous collateral circulation formed as a result of brachiocephalic and SVC obstruction from multiple pacemaker leads. Our patient's clinical presentation was extremely unique, and we did not find any cases during our literature search reporting a similar presentation. Multiple collaterals formed between the brachiocephalic and subclavian veins, and bilateral pulmonary veins in our patient allowed the injected air bubbles from the venous system to reach the left side of the heart and eventually the cerebrovascular system, resulting in these transient ischemic attacks. These attacks eventually resolved as the air bubbles were dissolved and washed away by the continuous blood flow. It is advisable to monitor the patient for possible venous stenosis and SVC syndrome after any device insertion during regular device follow-up appointments.
Collapse
Affiliation(s)
- Thinzar Shwe
- Cardiology Department, Staten Island University Hospital, New York, NY, USA
| | - Aneeqa Javed
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
- Address correspondence to: Aneeqa Javed, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.
| | - Ravi Patel
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
| | - Philippe Akhrass
- Cardiology Department, Staten Island University Hospital, New York, NY, USA
| |
Collapse
|
18
|
Silva Araújo C, Domingues RM, Couto P, Matos AR, Ângela CC. Central Venous Catheter-Associated Superior Vena Cava Syndrome. Cureus 2023; 15:e37756. [PMID: 37213957 PMCID: PMC10198581 DOI: 10.7759/cureus.37756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
Superior vena cava syndrome (SVCS) is caused by any obstruction to the superior vena cava (SVC); the most common causes are malignancy and extrinsic compression. The use of medical devices, such as central venous catheters, poses an important risk factor, as they cause changes in the blood flow and in the vessel wall. This report describes a case of a 70-year-old male with an implantable central venous port, due to previous neoplastic disease, as the cause of the SVCS. Authors advise that the placement of medical devices ought to be carefully accessed and constantly revised to be removed when no longer needed to prevent avoidable complications.
Collapse
Affiliation(s)
| | | | - Peniela Couto
- Internal Medicine, Hospital Central de Maputo, Maputo, MOZ
| | | | | |
Collapse
|
19
|
Mukhopadhyay M, Ghoshal PK, Ganguly D, Chatterjee N. Tetralogy of Fallot Presenting with Superior Vena Cava Syndrome - A Rare Presentation. Heart Views 2023; 24:54-58. [PMID: 37124433 PMCID: PMC10144409 DOI: 10.4103/heartviews.heartviews_62_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/22/2023] [Indexed: 02/24/2023] Open
Abstract
Tetralogy of Fallot (TOF) presenting with superior vena cava (SVC) syndrome is an exceedingly rare scenario. The diagnosis of this condition is still a difficult task due to its unspecific clinical features and unclear recommendations for the best diagnostic tools. We report an interesting case of a 23-year-old male who was found to have TOF with the presentation of SVC syndrome after a sequential diagnosis. The timely diagnosis helped in the successful management of the patient. Through this case, we want to make clinicians aware of such a rare association and its diagnosis.
Collapse
Affiliation(s)
| | - Pradip Kumar Ghoshal
- Department of Cardiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Debpratim Ganguly
- Department of Medicine, Midnapore Medical College and Hospital, Midnapore, West Bengal, India
| | - Nandini Chatterjee
- Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, India
| |
Collapse
|
20
|
Olix DJ, Carollo DS, Ural KG. Dexmedetomidine Used to Maintain Spontaneous Ventilation in a Patient With Anterior Mediastinal Mass and Superior Vena Cava Syndrome. Ochsner J 2023; 23:363-366. [PMID: 38143545 PMCID: PMC10741815 DOI: 10.31486/toj.23.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
Background: Anterior mediastinal masses (AMMs), which can be benign or malignant, are a common cause of superior vena cava (SVC) syndrome. Because of their location, AMMs can cause significant airway compromise during the perioperative period, so anesthetic management of a patient with SVC syndrome can present significant challenges. Case Report: A patient presented with SVC syndrome secondary to a large AMM. After careful consideration and discussion with the patient about the risks and benefits of various approaches, the decision was made to provide sedation using dexmedetomidine as the sole agent during image-guided biopsy. Conclusion: Patients who present with AMMs require careful anesthetic planning. Dexmedetomidine can be effective in achieving the primary objective of maintaining spontaneous respiration.
Collapse
Affiliation(s)
- Daniel J. Olix
- Department of Anesthesiology and Perioperative Medicine, Ochsner Clinic Foundation, New Orleans, LA
| | - Dominic S. Carollo
- Department of Anesthesiology and Perioperative Medicine, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA
| | - Kelly G. Ural
- Department of Anesthesiology and Perioperative Medicine, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA
| |
Collapse
|
21
|
Zhang Y, Wang Z, Zhang C, Chen K, Fang M, Wang H. Surgical treatment for Behcet's disease with acute superior vena cava syndrome. J Card Surg 2022; 37:5559-5563. [PMID: 36349719 DOI: 10.1111/jocs.17119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Behcet's disease (BD) is a multisystem vasculitis with unknown etiology. The involvement of superior vena cava (SVC) is reported in less than 2% of patients with BD. METHODS We report a patient with acute edema of neck and face associated with dyspnea as the primary manifestation. So a diagnosis of superior Vena Cava syndrome (SVCS) was made and the thickening wall of SVC was resected. An Operation was performed under cardiopulmonary bypass to remove the mass and thrombus for avoiding for pulmonary embolism. RESULTS The diagnosis of Behcet's disease (BD) didn't not be made until the recurrent oral and genital ulceration occurred 2 weeks later. The patient taked aspirin and prednisolone orally as prescribed and no recurrence were observed during the 30 months follow-up. CONCLUSIONS BD should be suspected in patients presenting with SVCS, when there is thickening of SVC, whether thrombosis or not. Early diagnosis and treatment are essential for management of BD.
Collapse
Affiliation(s)
- Yong Zhang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Zengwei Wang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Chunzhen Zhang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Ke Chen
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China.,Graduate School of China Medical University, Shenyang, China
| | - Minhua Fang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Huishan Wang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
| |
Collapse
|
22
|
Rijal A, Shrestha A, Chaudhary S, Shrestha A. Superior vena cava syndrome in a child with mediastinal mass: A case report. Clin Case Rep 2022; 10:e6647. [PMCID: PMC9684690 DOI: 10.1002/ccr3.6647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/17/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Facial puffiness as a consequence of superior vena cava syndrome (SVCS) can be a presentation from which the physician would have to conjecture a diagnosis of a mediastinal mass including lymphomas. Pediatric SVCS can rapidly progress and pose a greater challenge for airway protection as was in our case. Pediatric superior vena cava syndrome (SVCS) due to malignancy can be a rapidly progressive life‐threatening condition that leads physicians to decide between choosing either immediate therapeutic management or further diagnostic procedures considering the case at hand.
Collapse
Affiliation(s)
- Ashes Rijal
- Tribhuwan University, Institute of MedicineKathmanduNepal,Nepal Health FrontiersKathmanduNepal
| | - Anish Shrestha
- Tribhuwan University, Institute of MedicineKathmanduNepal
| | | | | |
Collapse
|
23
|
Madi D, Dsouza NV, Manoj MA, Achappa B, Boussios S. A Primary Mediastinal Monophasic Spindle-Cell Synovial Sarcoma with Superior Venacaval Obstruction. Diseases 2022; 10. [PMID: 36412599 DOI: 10.3390/diseases10040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/31/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Primary mediastinal sarcoma is a rare tumour that usually presents with nonspecific symptoms such as hoarseness, dyspnoea, and chest pain. Superior vena cava (SVC) syndrome is an extremely uncommon complication that is caused by the compression, invasion, and thrombosis of the SVC or brachiocephalic veins. SVC syndrome can present as asymptomatic cases or as rare life-threatening emergencies with upper airway obstruction and increased intracranial pressure. This report describes the case of a 58-year-old female who presented with swelling of the face, neck, and upper limbs associated with dyspnoea on exertion. The radiological investigations revealed a large well-defined central necrotic peripherally enhancing lesion in the superior mediastinum extending anteriorly with the compression of brachiocephalic veins. A histopathological examination detected spindle cells arranged in fascicles with nuclear atypia with immunohistochemistry positive for creatine kinase (CK), smooth muscle actin (SMA), desmin and CD99. These findings established the diagnosis of a mediastinal monophasic synovial sarcoma with SVC obstruction. The patient was initiated on palliative radiotherapy for the management of the SVC, followed by systemic biological treatment with the tyrosine kinase inhibitor pazopanib, and was clinically improved. It is essential to promptly diagnose and treat this condition, especially when SVC syndrome manifests.
Collapse
|
24
|
Aurangabadkar G, Lanjewar A, Jadhav U, Mayekar M, Ali S, Wagh P. Anterior mediastinal mass with superior vena cava syndrome: A rare presentation of germ cell tumor. J Family Med Prim Care 2022; 11:6506-6509. [PMID: 36618225 PMCID: PMC9810870 DOI: 10.4103/jfmpc.jfmpc_153_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
The objective of this case report is to highlight the clinical, radiological, and histopathological features of a case of a 33-year-old male patient, who presented to AVBRH, Sawangi (Meghe), Wardha, with an anterior mediastinal mass with superior vena cava syndrome and after detailed studies was diagnosed as a case of germ cell tumor which was further confirmed on immunohistochemistry staining.
Collapse
Affiliation(s)
- Gaurang Aurangabadkar
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Ajay Lanjewar
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India,Address for correspondence: Dr. Ajay Lanjewar, Associate Professor, Department of Respiratory Medicine, Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha - 442 001, Maharashtra, India. E-mail:
| | - Ulhas Jadhav
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Mrinmayee Mayekar
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Saood Ali
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Pankaj Wagh
- Department of Respiratory Medicine, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| |
Collapse
|
25
|
Curnis A, Milidoni A, Arabia G, Bontempi L, Cerini M, Salghetti F, Ahmed A, Ferraresi R, Mitacchione G, Mascioli G. Leadless pacemakers as a new alternative for pacemaker lead-related superior vena cava syndrome: A case report. Pacing Clin Electrophysiol 2022; 45:1051-1055. [PMID: 35579295 DOI: 10.1111/pace.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/19/2022] [Accepted: 05/06/2022] [Indexed: 01/07/2023]
Abstract
Superior vena cava (SVC) syndrome is a rare disease induced by thrombosis and consequent occlusion of SVC, negatively affecting morbidity and mortality. The incidence of SVC syndrome from central venous catheters and pacemaker or defibrillator leads is increasing. Optimal treatment of pacemaker or defibrillator-related SVC syndrome is not well defined. Lead extraction causes mechanical trauma to the vessel wall. In addition, subsequent device implantation on the contralateral side can be an added factor for venous occlusion. The use of leadless pacemakers could be an interesting option to reduce the risk of SVC restenosis after lead extraction. We report a clinical case of PM leads-related SVC syndrome referred to our centers and treated with transvenous lead extraction, leadless pacemaker implantation and subsequent percutaneous angioplasty and stenting of the SVC and left innominate vein.
Collapse
Affiliation(s)
- Antonio Curnis
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy
| | - Antonino Milidoni
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy
| | - Gianmarco Arabia
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy
| | - Luca Bontempi
- Department of Cardiology, ASST Bergamo Est, Bolognini Hospital, Seriate, Bergamo, Italy
| | - Manuel Cerini
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy
| | - Francesca Salghetti
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy
| | - Ashraf Ahmed
- Cardio-thoracic department, Electrophysiology and Electrostimulation Laboratory, University of Brescia, Brescia, Italy.,Cardiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Gianfranco Mitacchione
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco, University Hospital, Milan, Italy
| | - Giosuè Mascioli
- Cardiothoracic Department, Humanitas Gavazzeni, Bergamo, Italy
| |
Collapse
|
26
|
Inoue T, Fujii K, Kaneda T, Kitayama H. Mid-Term Patency of Spiral Saphenous Vein Graft for Malignant Superior Vena Cava Syndrome. Vasc Endovascular Surg 2022; 56:817-819. [PMID: 35961606 DOI: 10.1177/15385744221121205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reports documenting the mid-term patency of spiral saphenous vein grafts for superior vena cava syndrome in patients with advanced thoracic malignancy are, so far, scarce. The present report describes a 69-year-old man who suffered superior vena cava syndrome due to malignant invasion by advanced lung cancer. Since the huge mass in the anterior mediastinum was unresectable, a bypass from the left innominate vein to the right atrium using an autologous spiral saphenous vein graft was surgically created. Postoperatively, the patient received chemoradiotherapy and maintenance anticoagulant therapy, resulting in survival for 4 years without graft occlusion or recurrence of superior vena cava syndrome.
Collapse
Affiliation(s)
- Takehiro Inoue
- Department of Cardiovascular Surgery, 145696Mimihara General Hospital, Osaka, Japan
| | - Kosuke Fujii
- Department of Cardiovascular Surgery, Kishiwada City Hospital, Osaka, Japan
| | - Toshio Kaneda
- Department of Cardiovascular Surgery, 145696Mimihara General Hospital, Osaka, Japan
| | - Hitoshi Kitayama
- Department of Cardiovascular Surgery, 145696Mimihara General Hospital, Osaka, Japan
| |
Collapse
|
27
|
Ono M, Suzuki H, Matsumoto S, Takanari K, Kamei Y. Upper thoracic empyema and concomitant superior vena cava syndrome treated with reconstructive surgery using a pedicled omental flap. Nagoya J Med Sci 2022; 84:648-655. [PMID: 36237890 PMCID: PMC9529635 DOI: 10.18999/nagjms.84.3.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022]
Abstract
Superior vena cava (SVC) syndrome refers to a constellation of symptoms secondary to obstruction of blood flow through the SVC. In this condition, venous blood that usually drains into the SVC is diverted into the inferior vena cava (IVC) via collateral veins. Reconstructive surgery is challenging in such cases owing to the anomalous venous system. In this case report, we describe reconstructive surgery using a pedicled omental flap in a patient with upper thoracic empyema and concomitant SVC syndrome. A 68-year-old man underwent resection of malignant thymoma, the bilateral brachiocephalic veins, and a part of the right upper lobe, followed by polytetrafluoroethylene (PTFE) graft placement for venous system reconstruction, 2 years prior to presentation. He developed postoperative upper thoracic cavity empyema, which necessitated PTFE graft removal. Although the infection was controlled after 2 months, multiple right upper lobe pulmonary fistulas persisted, and the patient was referred to our department for further evaluation. Contrast-enhanced computed tomography revealed SVC syndrome characterized by SVC obstruction and consequent drainage of venous blood from the upper trunk into the IVC via collateral vessels. We debrided necrotic and infected tissues, and a pedicled omental flap was placed for upper lobe fistula coverage. The patient showed an uncomplicated postoperative course, and no recurrent empyema or pulmonary fistulas were observed 3 years postoperatively. Flaps associated with the SVC system show high venous pressures. The use of a pedicled omental flap was deemed feasible because this graft reaches the upper thorax even though it is associated with the IVC system.
Collapse
Affiliation(s)
- Masashi Ono
- Department of Plastic and Reconstructive Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Hirohisa Suzuki
- Department of Plastic and Reconstructive Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Shinsuke Matsumoto
- Department of Thoracic Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Keisuke Takanari
- Department of Plastic and Reconstructive Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Yuzuru Kamei
- Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
28
|
Lin D, Zhu X, Tian L, Qin C, Dong J, Zhou Q. A huge Ewing's sarcoma of the rib presenting with superior vena cava syndrome and dysphagia. Thorac Cancer 2022; 13:1726-1730. [PMID: 35445539 PMCID: PMC9161347 DOI: 10.1111/1759-7714.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 02/05/2023] Open
Abstract
A 24-year-old male patient was admitted to our center complaining of dizziness (superior vena cava syndrome [SVCS]), dysphagia and pain in the right chest wall. At the initial diagnosis, the patient had been found to have an irregular shaped 35 × 30 × 27 cm mass in the right side of his chest. On November 12, 2019, this patient received surgery in our center. The right sixth rib and the tumor were completely removed (R0), while preserving all the lung tissue and other organs in the chest. The patient recovered well after surgery, and his right lung was fully expanded.
Collapse
Affiliation(s)
- Dan Lin
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaomu Zhu
- Department of Pharmacy, West China Hospital of Sichuan University, Chengdu, China
| | - Long Tian
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Changlong Qin
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jingsi Dong
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qinghua Zhou
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
29
|
Pham LT. Treatment of pacemaker-induced superior vena cava syndrome by venoplasty with a coronary balloon. J Arrhythm 2021; 37:1351-1353. [PMID: 34621435 PMCID: PMC8485796 DOI: 10.1002/joa3.12602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/14/2021] [Accepted: 07/04/2021] [Indexed: 12/02/2022] Open
Abstract
Venous thrombosis or stenosis frequently occurs after implanting transvenous pacemaker leads, and it is usually asymptomatic. The reported incidence is 30%-64%. The mandatory treatments are balloon angioplasty, stenting, thrombolytic, mechanical thrombectomy, and venous grafting. We present a case with the special cooperation of an electrophysiologist and a coronary interventionist in Ha Noi Heart Hospital, Vietnam, to treat an implanted pacemaker patient with fracture ventricular lead and superior vena cava syndrome.
Collapse
|
30
|
Xiao W, Lin Q, Chen S, Li S, Lin C, Su S, You X. Catheterization of PICC through a superficial femoral vein for patients with superior vena cava syndrome using ECG positioning and ultrasound-guided technologies. J Vasc Access 2021; 24:397-401. [PMID: 34313170 DOI: 10.1177/11297298211035331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We herein demonstrate the efficacy of PICC placement through a superficial femoral vein in patients with superior vena cava syndrome using ultrasound guidance and electrocardiographic localization. The treatment of PICC disconnection was also discussed. METHODS The study enrolled 51 patients with superior vena cava syndrome. Ultrasound-guided technology and ECG positioning technology are employed to help these patients in catheterization. The puncture time, the number of punctures, and catheter tip position were recorded. The patient was followed up for at least 2 years. The complications and treatment during follow-up were recorded. RESULT The average puncture time was 32.13 ± 3.91 min. A total of 49 patients were successfully punctured once, while 2 patients failed in the first puncture. The main reason for puncture failure is that the inability of a guide wire to pass through. After the nurse removed the needle and pressed the puncture point until no rebleeding occurred, the puncture above the original puncture point was successful. X-ray examination revealed that the catheter tip was located in the inferior vena cava, above the diaphragm, near the right atrium. The success rate of catheterization was 100%. The visual analog scale (VAS) score was (2.44 ± 0.73) at the time of puncture, which was tolerable during the operation, and the patient did not complain of obvious pain following the operation. One patient developed complications of broken tube half a year after the puncture. Interventional physicians utilized angiography to locate the broken catheter. CONCLUSION It is safe and feasible to place PICC through a superficial femoral vein under ultrasound combined with ECG positioning technology in patients with superior vena cava syndrome.
Collapse
Affiliation(s)
- Weizhu Xiao
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Qiuju Lin
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shuping Chen
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shanshan Li
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Cuifen Lin
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shaoyan Su
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Xiaofang You
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| |
Collapse
|
31
|
Tonko JB, Black SA, Rinaldi CA. "Inside-Out" Central Venous Access approach with infraclavicular exit for right-sided CRT-D Implantation in bilateral brachiocephalic and superior vena cava occlusion. Clin Case Rep 2021; 9:CCR33980. [PMID: 34136221 PMCID: PMC8190511 DOI: 10.1002/ccr3.3980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/09/2021] [Accepted: 02/08/2021] [Indexed: 11/08/2022] Open
Abstract
The use of the "inside-out" approach with an infraclavicular exit site with a dedicated system in the presence of complex central venous occlusion is feasible and safe for the implantation of complex cardiac devices.
Collapse
Affiliation(s)
- Johanna B. Tonko
- Department of CardiologySt. Thomas HospitalLondonUK
- Faculty of Life Sciences and MedicineKing’s College LondonLondonUK
| | | | - Christopher A. Rinaldi
- Department of CardiologySt. Thomas HospitalLondonUK
- Faculty of Life Sciences and MedicineKing’s College LondonLondonUK
| |
Collapse
|
32
|
Chen W, Lei J, Wang Y, Tang X, Liu B, Li Z, Zhou Q. Case Report: Superior Vena Cava Resection and Reconstruction for Invasive Thyroid Cancer: Report of Three Cases and Literature Review. Front Surg 2021; 8:644605. [PMID: 34141718 PMCID: PMC8204692 DOI: 10.3389/fsurg.2021.644605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/07/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Thyroid cancer with massive invasion into the cervical and mediastinal great veins is extremely rare, and the surgical treatment is controversial, thus posing a great challenge for head and neck surgeons. Here, we report our successful experiences in reconstructing the superior vena cava (SVC) system to treat thyroid cancer with an extensive tumor thrombus growing intraluminally into the SVC. Case Presentation: From September 2019 to September 2020, three patients with superior vena cava syndrome(SVCS) caused by tumor thrombus invasion from thyroid cancer were continuously included in this series. After preoperative evaluation, radical resection and reconstruction of the SVC system with expanded polytetrafluoroethylene (EPTFE) grafts were performed. In addition, bypass support from the right internal jugular vein to the right femoral vein was routinely prepared intraoperatively to prevent a rise in central venous pressure (CVP). Postoperatively, SVC-related syndrome improved immediately after the operation. Imaging examination showed good function of the reconstructed venous system. The patients recovered well with no surgical complications and remain under continuous follow-up. Conclusions: Tumor growth into the SVC does not seem to be an absolute contraindication for surgery for thyroid carcinoma. Comprehensive treatment, including reconstruction of the SVC, is effective for relieving symptoms and preventing disease progression and is thus worth advocating. In addition, bypass support from the internal jugular vein to the femoral vein is easy to implement and can improve the safety of the operation.
Collapse
Affiliation(s)
- Wenjie Chen
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jianyong Lei
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yichao Wang
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaojun Tang
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Bin Liu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qinghua Zhou
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
33
|
Locke AH, Shim DJ, Burr J, Mehegan T, Murphy K, D'Avila A, Schermerhorn ML, Zimetbaum P. Lead-associated Superior Vena Cava Syndrome. J Innov Card Rhythm Manag 2021; 12:4459-4465. [PMID: 33936861 PMCID: PMC8081456 DOI: 10.19102/icrm.2021.120404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/28/2020] [Indexed: 11/23/2022] Open
Abstract
Superior vena cava (SVC) syndrome is a rare complication associated with transvenous cardiac implantable electronic devices that may present with a variety of manifestations. Various strategies such as transvenous lead extraction, anticoagulation, venoplasty, and stenting have been used to treat this condition, but the optimal management protocols have yet to be defined. Subcutaneous implantable cardioverter-defibrillator (ICD) (S-ICD) therapy can be an alternative option to a transvenous system for those who require future ICD surveillance. We present a case of lead-associated SVC syndrome where thoracic venous congestion due to SVC obstruction influenced preimplant S-ICD QRS vector screening. Following treatment of venous obstruction, QRS amplitude may change and patients who were not initially S-ICD candidates may later become eligible.
Collapse
Affiliation(s)
- Andrew H Locke
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David J Shim
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Tyler Mehegan
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kelsey Murphy
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - André D'Avila
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Marc L Schermerhorn
- Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Peter Zimetbaum
- Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
34
|
Maalej F, Achour I, Zaidi A, Thabet W, Chaabouni MA, Hammami B, Ben Mahfoudh K, Mnejja M, Charfeddine I. Retropharyngeal edema secondary to superior vena cava syndrome revealing Behcet's disease. Clin Case Rep 2021; 9:1453-1456. [PMID: 33768866 PMCID: PMC7981641 DOI: 10.1002/ccr3.3800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/05/2022] Open
Abstract
Retropharyngeal edema, uncommon in superior vena cava syndrome, can exceptionally represent the first manifestation of Behcet's disease, which should be taken into account in the differential diagnosis of this condition.
Collapse
Affiliation(s)
- Firas Maalej
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | - Imen Achour
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | - Anis Zaidi
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | - Wadii Thabet
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | | | - Bouthaina Hammami
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | | | - Malek Mnejja
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| | - Ilhem Charfeddine
- ENT DepartmentUniversity of Sfax, Faculty of Medicine of SfaxSfaxTunisia
| |
Collapse
|
35
|
Kopanczyk R, Al-Qudsi OH, Ganapathi AM, Potere BR, Pagel PS. Superior vena cava syndrome during veno-venous extracorporeal membrane oxygenation for COVID-19. Perfusion 2021; 36:630-633. [PMID: 33427042 DOI: 10.1177/0267659120987973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Superior vena cava (SVC) syndrome is typically associated with malignant tumors obstructing the SVC, but as many as 40% of cases have other etiologies. SVC obstruction was previously described during veno-venous extracorporeal membrane oxygenation therapy (VV ECMO) in children. In this report, we describe a woman with adult respiratory distress syndrome resulting from infection with coronavirus-19 who developed SVC syndrome during VV ECMO. A dual-lumen ECMO cannula was inserted in the right internal jugular vein, but insufficient ECMO circuit flow, upper body edema, and signs of hypovolemic shock were observed. This clinical picture resolved when the right internal jugular vein was decannulated in favor of bilateral femoral venous cannulae. Our report demonstrates that timely recognition of clinical signs and symptoms led to the appropriate diagnosis of an uncommon ECMO complication.
Collapse
Affiliation(s)
- Rafal Kopanczyk
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Omar H Al-Qudsi
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Asvin M Ganapathi
- Department of Cardiothoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Bethany R Potere
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Paul S Pagel
- Anesthesiology Service, The Clement J Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA
| |
Collapse
|
36
|
Oshiro K, Kanzaki G, Maruyama Y, Yokoo T. Permanent Hemodialysis Catheter Causing Superior Vena Cava Syndrome. Intern Med 2020; 59:3247. [PMID: 32788538 PMCID: PMC7807124 DOI: 10.2169/internalmedicine.5026-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kentaro Oshiro
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| | - Go Kanzaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| | - Yukio Maruyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| |
Collapse
|
37
|
Vemuri KS, Revaiah PC, Bootla D, Chauhan R, Nevali KP, Jandial A, Singh Sachdeva MU, Singh D, Rohit MK. Early T Cell Precursor Leukemia Presenting With Superior Vena Cava Syndrome and Cardiac Tamponade. JACC CardioOncol 2020; 2:805-809. [PMID: 34396298 PMCID: PMC8352309 DOI: 10.1016/j.jaccao.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Krishna Santosh Vemuri
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Pruthvi C. Revaiah
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Dinakar Bootla
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Rajeev Chauhan
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Krishna Prasad Nevali
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Aditya Jandial
- Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Man Updesh Singh Sachdeva
- Department of Hematology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Dushyant Singh
- Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Manoj Kumar Rohit
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
38
|
Nieves Condoy JF, Zúñiga Vázquez LA, Páez Hernández EM, Jiménez Herevia AE, Acuña Pinzon CL. Superior Vena Cava Syndrome Due to Thymic Carcinoma. Cureus 2020; 12:e11670. [PMID: 33391908 PMCID: PMC7769725 DOI: 10.7759/cureus.11670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The superior vena cava syndrome (SVCS) is caused by a mechanical obstruction; 90% are of neoplasic etiology (lung cancer (LC) and non-Hodgkin lymphoma (NHL) mostly), epithelial neoplasms of the thymus (NET) is a rare cause, thymic carcinoma (TC) causing less than 1% of cases. A 56-year-old male presented with a four-month history of dyspnea, dysphonia, facial and cervical edema and bilateral cervical lymphadenopathy. The tomography showed bilateral, mediastinal, retroperitoneal lymphadenopathies, and obstruction of the internal jugular vein, right apical pulmonary nodules. A superficial adenopathy biopsy was taken, which is not conclusive, so it was decided to take an image-guided biopsy. During its evolution, it presents asymptomatic cardiovascular changes; in extension studies, systemic disease is evidenced. The definitive histopathological study reported thymic carcinoma. Systemic treatment with chemotherapy and radiation therapy was planned.
Collapse
|
39
|
Blanco P, Esteban F, Leonardi I. Superior vena cava obstruction and mediastinal mass detected by point-of-care ultrasonography. J Clin Ultrasound 2020; 48:569-573. [PMID: 32333798 DOI: 10.1002/jcu.22847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/08/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Superior vena cava syndrome (SVCS) often relates to malignant causes such as lung tumors, metastatic cancer, or lymphomas. While the diagnosis relies nowadays on the use of contrast-enhanced thoracic computed tomography, ultrasonography may have an important value as a first-line imaging technique, particularly when used in point-of-care office-based settings. Here, we report the case of a 67-year-old male presenting with SVCS in whom ultrasound contributed to diagnosis.
Collapse
Affiliation(s)
- Pablo Blanco
- Medical Department, "Dr. Alejandro Raimondi" Nursing Home, Necochea, Argentina
| | - Fernando Esteban
- Medical Department, "Dr. Alejandro Raimondi" Nursing Home, Necochea, Argentina
| | - Ivana Leonardi
- Department of Pathology, Hospital "Dr. Emilio Ferreyra", Necochea, Argentina
| |
Collapse
|
40
|
Klein-Weigel PF, Elitok S, Ruttloff A, Reinhold S, Nielitz J, Steindl J, Hillner B, Rehmenklau-Bremer L, Wrase C, Fuchs H, Herold T, Beyer L. Superior vena cava syndrome. VASA 2020; 49:437-448. [PMID: 33103626 DOI: 10.1024/0301-1526/a000908] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The superior vena cava syndrome (SVCS) is caused by compression, invasion, and/or thrombosis of the superior vena cava and/or the brachiocephalic veins. Benign SVCS is separated from malignant SVCS. SVCS comprises a broad clinical spectrum reaching from asymptomatic cases to rare life-threatening emergencies with upper airway obstruction and increased intracranial pressure. Symptoms are correlated to the acuity and extent of the venous obstruction and inversely correlated to the development of the venous collateral circuits. Imaging is necessary to determine the exact underlying cause and to guide further interventions. Interventional therapy has widely changed the therapeutic approach in symptomatic patients. This article provides an overview over this complex syndrome and focuses on interventional therapeutic methods and results.
Collapse
Affiliation(s)
- Peter Franz Klein-Weigel
- Clinic for Angiology, Interdisciplinary Center of Vascular Medecine, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Saban Elitok
- Clinic for Nephrology, Endokrinology/Diabetology, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Andreas Ruttloff
- Clinic for Angiology, Interdisciplinary Center of Vascular Medecine, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Sabine Reinhold
- Clinic for Angiology, Interdisciplinary Center of Vascular Medecine, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Jessika Nielitz
- Clinic for Angiology, Interdisciplinary Center of Vascular Medecine, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Julia Steindl
- Clinic for Angiology, Interdisciplinary Center of Vascular Medecine, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | | | | | - Christian Wrase
- Diagnostic and Interventional Radiology, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Heiko Fuchs
- Diagnostic and Interventional Radiology, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| | - Thomas Herold
- Radiology, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Lukas Beyer
- Diagnostic and Interventional Radiology, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany
| |
Collapse
|
41
|
Shenoy G, Kim Y, Newmaster K, McGillen KL, Ruggiero F, Yee NS. Recurrent Superior Vena Cava Syndrome in a Patient with Sarcoidosis and Pancreatic Adenocarcinoma: A Case Report and Literature Review. Medicines (Basel) 2020; 7:E56. [PMID: 32899649 DOI: 10.3390/medicines7090056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022]
Abstract
Background: Superior vena cava (SVC) syndrome may result from extravascular compression or intravascular obstruction such as thrombosis. Recurrent venous thrombosis is typically associated with a hypercoagulable state such as malignancy, and inheritable or acquired coagulopathy. Sarcoidosis is a derangement of the immune system, and it has been associated with malignant diseases and hypercoagulation. The association of pancreatic cancer and sarcoidosis with SVC syndrome has not been reported previously. Here, we present a case of recurrent venous thrombosis causing SVC syndrome in a patient with pancreatic ductal adenocarcinoma and underlying thoracic sarcoidosis. Methods: The patient's electronic health record was retrospectively analyzed. Results: A 66-year-old woman with pancreatic adenocarcinoma was treated with neoadjuvant chemotherapy followed by Whipple procedure, before developing tumor recurrence in the liver. Her treatment course was complicated with repeated incidents of venous thrombosis in the presence of a central venous catheter leading to recurrent SVC syndrome, which resolved with anti-coagulation. Conclusions: This case raises a plausible inter-relationship between sarcoidosis, pancreatic cancer, and hypercoagulable state. We suggest that patients with multiple risk factors for developing venous thrombosis should be carefully monitored for any thrombotic event, and they may benefit from prophylactic anti-coagulation.
Collapse
|
42
|
Kiatsuranon P, Suwanpimolkul G. Pulmonary Nocardiosis with Superior Vena Cava Syndrome in a HIV-Infected Patient: a Rare Case Report in the World. Jpn J Infect Dis 2020; 74:151-153. [PMID: 32741927 DOI: 10.7883/yoken.jjid.2019.470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulmonary nocardiosis is a common disease in human immunodeficiency virus (HIV)infected patients. In most cases, the disease progresses slowly. Here, we have presented a case of pulmonary nocardiosis that rapidly progressed. A 35-year-old woman with acquired immune deficiency syndrome and superior vena cava (SVC) syndrome, who was previously lost to follow-up, presented to our hospital chronic non-productive cough. Her CD4 count was 33 cells/µL (4%). Chest X-ray revealed opacity in the right upper lobe of the lung, and the results of sputum acid-fast staining were negative. Anti-tuberculosis agents were prescribed. Two weeks later, superficial vein dilatation was noted on her chest wall and the chest X-ray revealed worse findings. Chest CT showed a heterogeneous mass measuring 9.6 × 9.8 × 8.3 cm in the right lung. Further, necrotic mediastinal nodes nearly obliterated the SVC. Gram-positive beaded branching filamentous organisms were identified in the sputum by modified acid-fast staining. Hence, she was diagnosed with pulmonary nocardiosis. Culture results confirmed the presence of Nocardia beijingensis with SVC syndrome. She responded to treatment. After 2 weeks of parenteral administration, we switched her to oral trimethoprim/sulfamethoxazole, which was later followed by antiretroviral agents.
Collapse
Affiliation(s)
- Phimkamon Kiatsuranon
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Gompol Suwanpimolkul
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand.,Tuberculosis Research Unit, Chulalongkorn University, Thailand.,Emerging Infectious Diseases Clinical Center, Thailand
| |
Collapse
|
43
|
Phancao A, El Banayosy A, Lee SP, Vanhooser DW, Harper MD, Horstmanshof DA, Long JW, Koerner MM. Successful venoplasty of superior vena cava stenosis in a patient with a total artificial heart after orthotopic heart transplantation due to primary graft failure. J Card Surg 2020; 35:2847-2852. [PMID: 32683723 DOI: 10.1111/jocs.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND With the limited number of available suitable donor hearts resulting in plateaued numbers of heart transplantations, short- and long-term mechanical circulatory support devices, including the implantation of total artificial hearts (TAHs) are modalities that are increasingly being used as treatment options for patients with end-stage heart failure. The superior vena cava syndrome has been described in this context in various disease processes. We report successful venoplasty for superior vena cava syndrome in a patient with a TAH. CASE PRESENTATION A 65-year-old man with a history of nonischemic cardiomyopathy had received a left ventricular assist device, and then 2 years later, underwent orthotopic heart transplantation using the bicaval anastomosis technique. The postprocedural course was complicated by primary graft failure, resulting in the need for implantation of a TAH. About 5 months after TAH implantation, he started to develop complications such as volume retention, swelling of the upper extremities, and was diagnosed to have a superior vena cava syndrome. The patient underwent a successful venoplasty of his superior vena cava by interventional radiology with resolution of upper body edema, normalization of renal, and liver function. CONCLUSION Potential fatal complications caused by catheter or wire entrapment in the right-sided mechanical valve of a TAH have been reported. We describe a safe method for the treatment of superior vena cava syndrome in patients with TAH.
Collapse
Affiliation(s)
- Anita Phancao
- Department of Medicine, Advanced Cardiac Care and 24/7 Shock Service, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - Aly El Banayosy
- Department of Medicine, Advanced Cardiac Care and 24/7 Shock Service, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - Stephen P Lee
- Department of Radiology, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - David W Vanhooser
- Department of Cardio-Thoracic Surgery, Advanced Cardiac Care, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - Michael D Harper
- Department of Medicine, Advanced Cardiac Care and 24/7 Shock Service, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma.,Department of Rural Health-Medicine/Cardiology, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Douglas A Horstmanshof
- Department of Medicine, Advanced Cardiac Care and 24/7 Shock Service, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - James W Long
- Department of Cardio-Thoracic Surgery, Advanced Cardiac Care, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma
| | - Michael M Koerner
- Department of Medicine, Advanced Cardiac Care and 24/7 Shock Service, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma.,Department of Rural Health-Medicine/Cardiology, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| |
Collapse
|
44
|
D'Abadie P, Ghaye B, Jamar F. Vertebral uptake of 99mTc-macroaggregated albumin during lung perfusion scanning. World J Nucl Med 2020; 19:271-272. [PMID: 33354184 PMCID: PMC7745876 DOI: 10.4103/wjnm.wjnm_44_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/23/2019] [Indexed: 11/08/2022] Open
Abstract
A 53-year-old female underwent a lung ventilation/perfusion scintigraphy (V/Q scan) in the workup of extensive thrombosis of the left subclavian and internal jugular veins. The perfusion lung scan visualized an atypical uptake in the thoracic vertebrae. A chest Computed Tomography (CT) scan demonstrated unusual tortuous and opacified thoracic superficial veins, collaterals of the lateral thoracic vein. Many venous collateral pathways can be developed in the case of superior vena cava syndrome. 99mTc-macroaggregated albumin particles may pass through the lateral thoracic vein and eventually through the vertebral venous plexus before being finally trapped by the vertebral capillaries. Besides right-to-left shunting, extrapulmonary uptake in the lung perfusion scintigraphy is very rare and may be used by collateral venous pathways.
Collapse
Affiliation(s)
- Philippe D'Abadie
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium
| | - Benoit Ghaye
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - François Jamar
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
45
|
Tonkin R, Sladden C. What lies downstream? A case of superior vena cava syndrome presenting in the dermatology clinic: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20919618. [PMID: 32547755 PMCID: PMC7249544 DOI: 10.1177/2050313x20919618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 75-year-old female presented with a 1 year history of a firm, diffusely swollen, and erythematous facial plaque. She had preceding unsuccessful investigations and treatment for angioedema. Full-skin examination revealed multiple prominent varicosities on the chest and abdomen. Superior vena cava syndrome was suspected. Solid facial edema (Morbihan's syndrome) and various infiltrates included in the differential diagnosis were ruled out with a skin biopsy. Chest computed tomography confirmed a complete superior vena cava thrombosis. Extensive workup for associated malignancy has to date been unremarkable, and as yet an underlying cause remains to be found.
Collapse
Affiliation(s)
- Rochelle Tonkin
- University Hospital of Northern British Columbia, Prince George, BC, Canada.,Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Christopher Sladden
- University Hospital of Northern British Columbia, Prince George, BC, Canada.,Department of Dermatology & Skin Science, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
46
|
Wei S, Liu J, Li X, Song Z, Dong M, Zhao H, Zhao Q, Chen G, Chen J. A retrospective stenting study on superior vena cava syndrome caused by lung cancer. Thorac Cancer 2020; 11:1835-1839. [PMID: 32438532 PMCID: PMC7327698 DOI: 10.1111/1759-7714.13461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 11/29/2022] Open
Abstract
Background Superior vena cava syndrome (SVCS) is a common condition predominantly caused by lung cancer. The presence of symptoms of SVCS, such as elevated intracranial pressure and laryngeal edema, indicates an unfavorable prognosis for lung cancer patients. Superior vena cava (SVC) stenting is the first‐line treatment for SVCS. In this study, we retrospectively analyzed SVCS cases treated with stenting in our center to explore the safety and effectiveness of stenting in the treatment of SVCS. Methods We reviewed 16 patients with SVCS caused by lung cancer who were treated at our center with endovascular stenting between 2016 and 2018. Patient information such as age, sex, type of lung cancer, obstruction condition, complications, survival time, and postoperative treatments are summarized. Results There were no treatment‐related complications in the perioperative period in any of the patients. Examination at postoperative day 2 indicated that the accompanying SVCS symptoms had improved in all patients. The median survival of patients treated along with combined postoperative chemotherapy and antivascular targeted therapy reached seven months (1–18 months). Conclusions SVC stenting is effective as a first‐line treatment modality for patients with SVCS caused by lung cancer. In combination with other treatment modalities, it can significantly alleviate symptoms and reduce complications, and thus it plays an important role in the treatment of patients with SVCS caused by lung cancer.
Collapse
Affiliation(s)
- Sen Wei
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinghao Liu
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Li
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Zuoqing Song
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Dong
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Honglin Zhao
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Qingchun Zhao
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Gang Chen
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
47
|
Thukral S, Vedantham S. Catheter-Based Therapies and Other Management Strategies for Deep Vein Thrombosis and Post-Thrombotic Syndrome. J Clin Med 2020; 9:E1439. [PMID: 32408611 PMCID: PMC7290684 DOI: 10.3390/jcm9051439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 02/07/2023] Open
Abstract
Acute deep vein thrombosis (DVT) causes substantial short-term and long-term patient morbidity. Medical, lifestyle, and compressive therapies have been investigated for the prevention of pulmonary embolism (PE) and recurrence of venous thromboembolism (VTE). However, patient-centered outcomes such as resolution of presenting DVT symptoms and late occurrence of post-thrombotic syndrome (PTS) have not been prioritized to the same degree. Imaging-guided, catheter-based endovascular therapy has been used in selected patients to alleviate these sequelae, but important questions remain about their optimal use. In this article, we review the available evidence and summarize the rationale for use of catheter-based therapy in specific patient groups.
Collapse
Affiliation(s)
- Siddhant Thukral
- School of Medicine, University of Missouri—Kansas City, Kansas City, MO 64108, USA;
| | - Suresh Vedantham
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| |
Collapse
|
48
|
Miller VM, Pereira SJ. Surgical management of catheter-related right atrial thrombus with superior vena cava syndrome A Case Report. J Card Surg 2020; 35:1673-1675. [PMID: 32365429 DOI: 10.1111/jocs.14613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
There are no consensus guidelines on the management of catheter-related right atrial thrombus. We present the case of a 29-year-old female with end-stage renal disease who was found to have a large right atrial thrombus associated with her tunneled dialysis catheter during preoperative workup for renal transplant. She exhibited signs and symptoms of superior vena cava syndrome and NYHA class III congestive heart failure. She was successfully treated with surgical thrombectomy and demonstrated rapid resolution of her symptoms postoperatively.
Collapse
Affiliation(s)
- Vanessa M Miller
- Division of Cardiovascular Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Sara J Pereira
- Division of Cardiovascular Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
49
|
Alvarez-Cardona J, Mitchell J, Lenihan D. Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment? CME. Methodist Debakey Cardiovasc J 2020; 15:289-299. [PMID: 31988690 DOI: 10.14797/mdcj-15-4-289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The acknowledgement of cardiovascular disease as one of the leading causes of mortality and morbidity among cancer survivors is the cornerstone of the growing field of cardio-oncology. Although standardizing treatment for any given disease is often considered ideal, it is important to recognize the value of pursuing a practical and personalized approach when caring for an oncology patient to minimize the risk of treatment-related cardiotoxicity. We hereby discuss a series of cases that illustrate the ways vascular toxicity can manifest in patients with cancer and, when appropriate, provide scientific evidence that supports clinical decision making. We also raise questions about the complex management of these patients while shedding light on future research in this growing field.
Collapse
|
50
|
Affiliation(s)
- Fumiya Ogasawara
- Department of Hematology, Kochi Medical School, Kochi University, Japan
| | - Yu Nakatani
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Japan
| | - Kensuke Kojima
- Department of Hematology, Kochi Medical School, Kochi University, Japan
| |
Collapse
|