Superior vena cava syndrome

TABLE 96-6. Tumors Most Commonly Associated with Superior Vena Cava Syndrome... 

Wudel LJ, Nesbitt JC. Superior vena cava syndrome. Curr Treat Options Oncol 2001 2 77-91. 

Suggested Alternatives for Differential Diagnosis Abdominal aneurysm, aortic dissection, pleural effusion, subarachnoid hemorrhage, superior vena cava syndrome, hantavirus pulmonary syndrome, mediastinitis, fulminate mediastinal tumors pneumonia, gastroenteritis, meningitis, ecthyma, rat bite fever, spider bite, leprosy, plague, tularemia, coccidioidomycosis, diphtheria, glanders, histoplasmosis, psittacosis, typhoid fever, and rickettsial pox. 

Hershey CO, McVeigh RC, Miller RP. Transient superior vena cava syndrome due to propylthiouracil therapy in intrathoracic goiter. Chest 1981 79(3) 356-7. 

Fig. 1.42 Patient affected by superior vena cava syndrome. Note well-developed collateral vessels...

Figi 1.43 Contrast venography of both subclavian veins in a patient with superior vena cava syndrome. He carried a monocatheter pacing system on the left (implanted 4 years earlier) and had two abandoned leads on the right (the pacemaker, implanted 21 years earlier, had been removed from the right pocket due to local infection). Subocclusive obstruction between the right subclavian and innominate veins (a). Total obstruction is visible in the first tract of the superior vena cava arrow). Occlusive obstruction visible in the middle tract of the left subclavian vein h) arrow)... 

Ary ana A, Sobota KD, Esterbrooks DJ, Gelbman Al (2007) Superior vena cava syndrome induced by endocardial defibrillator and pacemaker leads. Am J Cardiol 99(12) 1765-1767... 

Melzer C, Lembcke A, Ziemer S et al (2006) Pacemaker-induced superior vena cava syndrome clinical evaluation of long-term follow-up. Pacing Clin Electrophysiol 29(12) 1346-1351... 

Bakir I, La Meir M, Degrieck I et al (2005) Contralateral replacement of pacemaker and leads following laser sheath extraction and concomitant stenting for superior vena cava syndrome. Pacing Clin Electrophysiol 28(10) 1131-1134... 

Gilard M, Perennes A, Mansourati J et al (2002) Stent implantation for the treatment of superior vena cava syndrome related to pacemaker leads. Europace 4(2) 155-158... 

Chan AW, Bhatt DL, Wilkoff BL et al (2002) Percutaneous treatment for pacemaker-associated superior vena cava syndrome. Pacing Clin Electrophysiol 25 1628-1633... 

Gross CM, Kramer J, Waigand J et al (1997) Stent implantation in patients with superior vena cava syndrome. A JR Am J Roentgenol 169 429-432... 

Schindler N, Vogelzang RL (1999) Superior vena cava syndrome. Experience with endovascular stents and surgical therapy. Surg Clin North Am 79 683-694... 

The second simation that dictates an epicardial approach is when there is no reasonable venous access to the heart from the superior venous stractures. This is most commonly encountered in patients who have undergone a Senning or Mustard procedure with subsequent development of obsduction at the junction of the superior vena cava and the intra-atrial baffle. In such patients, superior vena cava syndrome is possible, with elevated SVC pressures and concomitant additional problems, but more often, venous return from the upper body diverts to the inferior vena cava by azygous connections. In the latter situation, there is no elevation of SVC pressures and no hemodynamic consequences of the obstmction, but one cannot pass a pacing lead from the subclavian vein into the heart. This simation may also exist in any padent who has had numerous prior operations and who lacks adequate subclavian vein caliber. 

Goudevenos JA, Reid PG, Adams PC, Holden MR Williams DO. Pacemaker-induced superior vena cava syndrome report of four cases and review of the literature. Pacing Clin Electrophysiol 1989 12 1890-1895. 

Chamorro H, Rao G, Wholey MH. Superior vena cava syndrome a complication of transvenous pacemaker implantation. Radiology 1978 126 377-378. 

Fig.5.2. Same patient as in Fig. 5.1. At the time of endolumi-nal treatment of superior vena cava syndrome, fresh thrombus had formed in the right subclavian and right brachiocephalic vein. Local fibrinolytic infusion was started before stenting to avoid pulmonary embolism after restoration of flow...

Bernstein EF, Knowles HJ, Saced M (1994) Should superior vena cava syndrome be treated by surgery any more. Cardiovasc Surg 2 605-606... 

Hochrein J, Bashore TM, Claughlin MP, Harrison JK (1998) Percutaneous stenting of superior vena cava syndrome a case report and review of the literature. Am J Med 104 78-84... 

Recto MR, Bousamra M, Yeh T Jr (2002) Late superior vena cava perforation and aortic laceration after stenting to treat superior vena cava syndrome secondary to fibrosing mediastinitis. J Invasive Cardiol 14 624-629 Rosch J, Bedell JE, Putnam J et al. (1987) Gianturco expandable wire stents in the treatment of superior vena cava syndrome recurring after maximum tolerance radiation. Cancer 60 1243 1246... 

Rosch J, Uchida BD, Hall LD et al. (1992) Gianturco-Rdsch expandable Z stents in the treatment of superior vena cava syndrome. Cardiovasc Intervent Radiol 15 319-327 Saced M, Newman GE, McCavin RL et al. (1987) Stenoses in dialysis fistulas treatment with percutaneous angioplasty. Radiology 164 693-697... 

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