Palliative Treatment of Superior Vena Cava Syndrome with Nitinol Stents

This study aims to retrospectively evaluate the outcomes following nitinol stent placement for malignant superior vena cava syndrome. A total of 25 patients with thoracic malignancies were treated with self-expanding nitinol stents for superior vena cava syndrome (E*Luminexx [Bard GmbH/Angiomed, Karlsruhe, Germany], Sinus-XL [OptiMed Medizinische Instrumente GmbH, Ettlingen, Germany], and Zilver Vena [Cook Medical Inc., Bloomington, IN]). It was seen that the procedural success rate was 76% with all stents deployed as intended and no procedure-related complications but in five patients with 50% residual stenosis and one patient with stent occlusion within 48 hours after stent deployment. Stent occlusion occurred in further two patients during follow-up: one patient developed infection, thrombosis, and occlusion in the stent seen at 2-month follow-up, and one patient had stent occlusion at 4-month follow-up. The clinical success rate was 96%. Stent compression leading to a greater than 50% reduction in stent diameter was observed in three patients at follow-up. Overall 22 patients died at a mean follow-up of 3.5 months for reasons related to their underlying malignancy. It was concluded that the stent treatment for superior vena cava syndrome is a safe treatment with good clinical effect in patients with superior vena cava syndrome in the terminal phase of malignant disease. In this small patient population, no trends were observed which would suggest that outcomes vary by stent type, though additional, large-scale studies are needed.