Safety and outcomes of endovascular treatment with stent implantation in patients with malignant superior vena cava syndrome: single-center experience.

Abstract

Introduction: Superior vena cava syndrome (SVCS) comprises a range of symptoms and signs of mechanical obstruction of the SVC lumen.

Objectives: The study aimed to investigate the effectiveness and safety of endovascular treatment (EVT) with stent implantation in patients with SVCS due to malignancy.

Materials and methods: This retrospective observational study included patients with malignant SVCS who received EVT with stent implantation between July 2014 and November 2024. The efficacy of the procedure was evaluated based on technical success, clinical symptom relief, periprocedural complication rate, and recurrence rate, with follow‑up conducted 1 month postprocedure.

Results: A total of 56 stents were implanted in 40 patients (57.5% women) in 47 procedures. Thirty‑three patients (81.5%) underwent conventional anticancer treatment prior to the procedure (previously treated patients [PTPs]) and 7 (17.5%) were naive to prior anticancer treatment (not previously treated patients [NPTPs]). The EVT with stent implantation was technically successful in 39 patients (97.5%). At least moderate reduction in symptoms was observed in 81.8% of the individuals in the PTP group and in 85.7% in the NPTP group (P = 0.67). In 28 patients (70%), only 1 stent was required. The overall complication rate was 12.5%. The primary stent patency rate was 92.3% (90.6% vs 100%; P = 0.41 for the PTP vs NPTP group, respectively).

Conclusions: The EVT with stent placement is effective in symptomatic patients with SVCS due to malignancy. The procedure is associated with acceptable complication and reocclusion rates.