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

Introduction: Superior vena cava syndrome (SVCS)comprises a range of symptoms and signs of mechanical obstruction of the SVC lumen. Objectives: To investigate the effectiveness and safety of endovascular treatment (EVT) with stent implantation in patients with SVCS due to malignancy. Materials and methods: Retrospective observational study of patients suffering from 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 symptoms relief, periprocedural complications rate and recurrence rate, with a followup conducted one month post-procedure. Results: A total of 56 stents were implanted in 40 patients (57.5% female) during 47 procedures. Thirty-three patients (81.5%) patients underwent conventional anticancer treatment prior to the procedure (PTP, previously treated patients) and seven (17.5 %) were native to prior anticancer treatment (NPTP, no-previously treated patients). The EVT with stent implantation was technically successful in 39 (97.5%) patients. At least moderate reduction in symptoms was observed in 81.8% of cases in PTP group and in 85.7% of cases in NPTP group (p=0.67). In 28(70.0%) patients only one stent was required. The overall complications rate was 12.5%. The primary stent patency rate was 92.3% (90.6% vs. 100%, P = 0.41 for 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 complications and reoclussions rate.