Secondary endovascular repair of a reconstructed superior vena cava in a patient with a malignant thymic epithelial neoplasm

Thymic epithelial tumors can cause venous obstruction from compression or direct invasion of the superior vena cava (SVC) or the innominate veins. We report a case of a 40-year-old patient with a Masaoka stage III thymoma that resulted in obstruction of the left innominate vein and extrinsic compression of the SVC. All macroscopic tumors were resected together with ligation of the left innominate vein and reconstruction of the SVC with an ePTFE graft. Early graft thrombosis occurred in the first postoperative month with clinical signs of SVC syndrome. Endovascular repair was performed with the deployment of self-expanding nitinol stents, resulting in immediate relief of symptoms. The stented graft has remained patent for a follow-up period of 7 months.