Endovascular stent provides more effective early relief of SVC obstruction compared to balloon angioplasty.

Abstract

OBJECTIVE:

To determine whether superior vena cava (SVC) stent implantation is superior to balloon angioplasty for relieving SVC stenosis.

BACKGROUND:

SVC stent and balloon dilation have been used as treatment for SVC stenosis. Although safe and effective, outcome data comparing the two methods are limited.

METHODS:

A Pediatric Cardiac Care Consortium review identified SVC stenosis. Patients who required SVC intervention were divided into two subgroups-balloon dilation (Group A) and stent implantation (Group B). Logistic regression and the log-rank test were used to test the need for re-intervention within 6 months after the initial procedure.

RESULTS:

SVC intervention was performed on 210/637 patients with SVC stenosis (33%). There were 108/210 (51%) patients with balloon dilation (Group A) and 102/210 (49%) with stent implantation (Group B). Re-intervention within 6 months of the initial intervention was more common in Group A compared to Group B [Group A = 31/40 (77.5%); Group B = 5/22 (22.7%)]. The odds-ratio for re-intervention within 6 months of the initial procedure for balloon vs. stent, is 7.3 [95% CI: (2.91, 22.3), P < 0.0001]. In addition, during the first 6 months after an intervention for SVC stenosis the proportion of patients with stent implantation that remained free of re-intervention was significantly higher than after balloon angioplasty (log-rank test, P < 0.0001). Neither age nor weight was significantly associated with the need for re-intervention.

CONCLUSIONS:

SVC stent implantation is more effective than angioplasty in relief of SVC obstruction. Weight and age are not risk factors for early re-intervention.

• Authors: Osamah Aldoss, Nofil Arain, Jeremiah Menk, Lazaros Kochilas, Daniel Gruenstein
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 83 Issue 7 Pg. E272-6 (Jun 01 2014) ISSN: 1522-726X [Electronic] United States
• PMID: 22431347 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.

Topics

• Adolescent
• Adult
• Angiography
• Angioplasty, Balloon (methods)
• Child
• Child, Preschool
• Endovascular Procedures (methods)
• Female
• Follow-Up Studies
• Humans
• Infant
• Infant, Newborn
• Male
• Retrospective Studies
• Stents
• Superior Vena Cava Syndrome (diagnosis, surgery)
• Time Factors
• Treatment Outcome
• Young Adult