Endovascular Recanalization of a Port Catheter-associated Superior vena Cava Syndrome. Issue 5 (September 2015)

• Record Type: Journal Article
• Authors: Tonak, Julia; Fetscher, Sebastian; Barkhausen, Jörg; Goltz, Jan Peter
• Is Part Of: Journal of vascular access. Volume 16:Issue 5(2015)
• Page Start: 434
• Page End: 436
• Publication Date: 2015-09
• Subjects: Endovascular revascularization of superior vena cava superior -- Interventional radiology -- Occlusion of superior vena cava -- Superior vena cava syndrome; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.5301/jva.5000402
• Languages: English
• ISSNs: 1129-7298

Abstract

Purpose: Superior vena cava (SVC) syndrome owing to benign etiology is rare and endovascular techniques have been advocated as the treatment of choice. We report a case of endovascular revascularization of a port catheter-associated complete occlusion of the SVC with reversed flow in the azygos vein. Methods: In this setting using a sheath in combination with its dilatator to pass the occlusion of the SVC after neither a diagnostic catheter nor a PTA balloon would pass the lesion may be a valid option. A dual venous approach was established using the right common femoral vein and an indwelling port catheter in the right cephalic vein to dilate and stent the lesion. Finally, a port may be implanted after the revascularization had been successful. Results: Passage through the port catheter-associated occlusion of the SVC was only possible by use of the sheath in combination with its dilatator. A dual venous access by the femoral approach and the indwelling central catheter is helpful in treating a SVC occlusion. Conclusions: Long-term central venous catheters may cause SVC syndrome, especially with a catheter tip located too far cranially. An endovascular revascularization of a complete occlusion of the SVC represents the therapy of choice.