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Chirurgie 6. August 2015

Stent-supported percutaneous transluminal angioplasty in patients suffering from symptomatic benign or malignant central venous occlusive disease

Background: The aim of this study was to investigate the outcome of patients suffering from benign or malignant superior vena cava (SVC), brachiocephalic (BCV), and subclavian (SV) vein lesions treated with nitinol stents.

Methods: Retrospective analysis of consecutive patients in a university-based tertiary care center.

Results: Twenty-two patients suffering from central venous occlusive disease (CVD) (9 malignant, mean age 58 years; 13 benign, mean age 66 years) were treated 2/2003–1/2012. In total, 89 % of malignant central venous occlusive disease (mCVD) patients underwent successful primary stenting (one reintervention 6 months after primary stenting). Two stent occlusions (22 %) were seen at last follow-up. All mCVD patients died within a median follow-up of 2 months (range: 0.8–54 months). In all, 92 % of benign central venous occlusive disease (bCVD) patients underwent primary stenting of SV (n = 8), BCV (n = 5), and SVC (n = 1). Six repeat interventions were performed in 42 % of patients. There was one stent occlusion (8 %) at last follow-up. Of all, 69 % of bCVD patients died within a median follow-up of 12.7 months (range: 1.3–82 months); 22 % of mCVD and 8 % of bCVD patients underwent bypass surgery as bail out procedure due to primary (n = 2) or secondary (n = 1) endovascular failure. All CVD patients experienced immediate post-interventional relief of symptoms.

Conclusion: Technical success of CVD stenting is high and leads to immediate relief of symptoms in patients with short life expectancy.

K. Linni, A. Ugurluoglu, M. Aspalter, W. Hitzl, T. Hölzenbein, European Surgery 4/2015

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