Combined interventional therapy for malignant vena cava obstruction / 中国微创外科杂志

ABSTRACT

Objective To evaluate the effectiveness of combined treatment with thrombolysis,PTA,and endovascular stent placement for malignant obstruction of vena cava.Methods The study included 29 patients with malignant obstruction of vena cava(superior,8 patients;inferior,21 patients).The patients underwent treatment of PTA and endovascular stent placement(for patients with complete vena cava obstruction or patients with incompletely expanding stent),or endovascular stent placement(for patients with incomplete vena cava obstruction),or endovascular stenting combined with thrombolysis(for patients with thrombosis in vena cava),respectively.Results A total of 29 stents was implanted,with a success rate of stent placement of 100%.Symptoms of SVC obstruction completely disappeared in the 8 patients.Scores of patients' IVC syndrome were declined from 4～5(median,4.2) preoperatively to 0～2(median,0.3) postoperatively,with statistically significant difference(Z=-55.245,P=0.000).Follow-up checkups for 1～20 months(mean,6.2 months) in the 29 patients found patent vena cava.There were no serious complications except for vena cava laceration in 1 patient and stent displacing to the right atrium on the third day after therapy in 1 patient.Conclusions The combined treatment of thrombolysis,PTA,and endovascular stenting is safe and effective in the treatment of vena cava obstruction.