A free powerpoint ppt presentation displayed as a flash slide show on id. We report a combined percutaneous endovascular approach, including thrombus aspiration and catheter directed local thrombolysis, followed by systemic thrombolytic therapy to treat severe superior vena cava syndrome in a 2. Superior vena cava syndrome is diagnosed by ultrasound, chest xray, ct scan, and in some cases biopsy. In superior vena cava syndrome svcs, this vein has. William hunter first described the syndrome in 1757 in a patient with syphilitic aortic aneurysm. Mar 17, 2015 superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. May 05, 2019 superior vena cava svc syndrome is a result of obstruction of flow through the svc, the major venous outlet for deoxygenated blood from the head, neck, and upper torso to the heart.
Clinical practice from the new england journal of medicine superior vena cava syndrome with malignant causes. Superior vena cava syndrome symptoms, diagnosis and. Superior vena cava svc syndrome has a characteristic and often striking clinical presentation, which can occa sionally be life threatening. The may be due to obstruction external compression benign or malignant, fibrosis or thrombosis. Superior vena cava syndrome svcs refers to the clinical syndrome with symptoms that results from this obstruction. Superior vena cava obstruction evaluation with mdct.
Svcs is a medical emergency if associated with laryngeal or cerebral edema. Malignancyrelated superior vena cava syndrome uptodate. Superior vena cava syndrome with malignant causes nejm. Ppt superior vena cava syndrome powerpoint presentation.
This impaired venous drainage results in venous hypertension and subsequent venous congestion. The radiologist labelled the thrombosis as chronic, given the decreased venous diameter and the calcified, dense, heterogeneous thrombus. Superior vena cava svc syndrome is a clinical condition that occurs as a result of obstruction of the svc, leading to interrupted venous return from the head, thorax, and upper extremities to the right atrium. Percutaneous endovascular catheter aspiration thrombectomy of. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. Definition the superior vena cava is the major vein in the chest that carries blood from the upper part of the body in to the heart. It can occur due to both benign and malignant causes with the. Sep 01, 2017 the superior vena cava is one of the primary veins within our bodies.
Superior vena cava svc syndrome is a collection of clinical signs and symptoms. It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. The superior vena cava svc located in anterior mediastinum, carries blood from the head, neck, upper extremities and upper chest. Superior vena cava obstruction radiology reference article. Review of evolving etiologies, implications and treatment strategies. Introduction superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. The superior vena cava is a large vein located in the upper chest, which collects blood from the head and arms and delivers it back to the right atrium of the heart. It was first described by william hunter in 1757, in a patient with a large syphilitic aortic aneurysm compressing the svc3,5. The svc is relatively pliable and can be easily compressed by a mass or an intravascular device. Superior vena cava syndrome an overview sciencedirect topics. Superior vena cava syndrome affects 15,000 patients each year in the united states, and its incidence continues to grow as the prevalence of intravascular devices increases. It is a largediameter 24 mm short length vein that receives venous return from the upper half of the body, above the diaphragm. Superior vena cava syndrome svcs is a group of signs and symptoms resulting from compression or occlusion of the superior vena cava. Superior vena cava svc syndrome occurs in approximately 15,000 people in the united states each year.
Superior vena cava syndrome svcs results from the impair. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise. Superior vena cava syndrome svcs is a medical emergency which consists of the obstruction of blood flow through the superior vena cava. Superior vena cava svc syndrome occurs due to mechanical obstruction of blood flow to the right atrium of the heart through svc. Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava.
Infections such as tuberculosis, and extrinsic compression such as syphilitic aortic aneurysm, thymoma or thyroid goitre, are also known to cause superior vena cava syndrome. The presence of these collateral vessels is an important ancillary ct finding of superior vena cava syndrome, with a sensitivity of 96% and a specificity of 92% 4. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading the svc wall. Malignancies primarily lung cancer are the underlying cause of 8085% of cases, leaving 1520% caused by various benign conditions, including sclerosing. Epidemiology svcs develops in about 510% of patients with. Airway obstruction mimicking superior vena cava syndrome in. In anatomy, a persistent left superior vena cava plsvc is the most common variation of the thoracic venous system, is prevalent in 0. The resulting increased venous pressure in the upper body may cause edema of the head, neck, and upper. Superior vena cava syndrome in thoracic malignancies. The photograph shows massive engorgement of collateral subcutaneous veins of the chest and abdomen in a 58yearold man with partial obstruction of the superior vena.
Superior vena cava syndrome symptoms, diagnosis and treatment. Svcs is the manifestation of impaired return of venous blood from the face, neck, upper extremities, and upper thorax. Svcs is a medical emergency if associated with laryngeal. Superior vena cava svc obstruction can occur from extrinsic compression, intrinsic stenosis, or thrombosis. Symptoms of the syndrome include shortness of breath. Description superior vena cava syndrome is a partial occlusion of the. Pdf on jun 1, 2012, khaldoon shaheen and others published superior vena cava syndrome find, read and cite all the research you need on researchgate. Register for 3 free subscriberonly articles each month. Currently, svc syndrome is generally due to cancer or thrombotic events. Superior vena cava syndrome svcs is a group of symptoms that can occur in people who have lung cancer, lymphoma, or other cancers that involve the center of the chest. The superior vena cava was successfully bypassed in a patient with superior vena cava syndrome due to granulomatous mediastinitis. Michael mcfadden the superior vena cava and its important intrathoracic venous tributaries are located in a tight compartment within the superior mediastinum, immediately adjacent and anterior to the trachea and right main bronchus. The treatment of superior vena cava syndrome is directed toward the exact underlying cause.
Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 % of all lung cancer patients. If you continue browsing the site, you agree to the use of cookies on this website. Treatment should also be individualized and should not be undertaken until a diagnosis is obtained. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or. A spiral vein graft constructed from autogenous vein was utilized. Malignancies are the main cause and are considered an oncologic emergency. It transports blood from our arms, chest, neck, and head to our hearts. Treatment depends on the etiology of the obstructive process. Review of evolving etiologies, implications and treatment.
Inferior vena cava definition of inferior vena cava by. Superior vena cava svc syndrome results from any condition that leads. Total absence of superior vena cava svc is a very rare anomaly, and the patient usually suffers from svc syndrome or conduction disturbances. Superior vena cava syndrome statpearls ncbi bookshelf. The superior vena cava syndrome svcs comprises various symptoms due to occlusion of the svc, which can be easily obstructed by pathological conditions eg, lung cancer, due to the low internal venous pressure within rigid structures of the thorax trachea, right bronchus, aorta. Superior vena cava syndrome, topics in thoracic surgery, paulo f. Superior vena cava syndrome definition of superior vena. The superior vena cava is formed by the junction of the left and right innominate brachiocephalic veins and is tasked. Nonmalignant superior vena cava syndrome in a patient.
The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading. This procedure was performed on the fifth postoperative day after major surgery. Lung cancer is the most common cause of superior vena cava syndrome svcs and requires timely recognition and management. A reassessment of the clinical applications of the superior vena cava syndrome. The diagnosis of superior vena cava syndrome can be made with the typical findings above.
To access free multiple choice questions on this topic, click here. Pdf on jan 30, 2009, maria del valle and others published. Most cases are caused by underlying intrathoracic malignancy, of which up to 95% are due to lung cancer or nonhodgkins lymphoma. Malignant obstruction can be caused by direct invasion of tumor into the svc, or by external compression of the svc by an adjacent pathologic process involving the right lung, lymph nodes, and other mediastinal structures, leading to stagnation of flow and. Thrombosis of the superior vena cava, however, is less common when it is not related to central venous catheters in the subclavian vein or the superior vena cava. Superior vena cava syndromea proposed classification system. The superior vena cava syndrome svcs comprises various symptoms due to occlusion of the svc, which can be easily obstructed by pathological conditions eg, lung cancer, due to the low internal. A 58yearold man presents with a 2week history of progressive dyspnea on exertion, neck swelling, decreased appetite, and fatigue. Superior vena cava syndrome svcs, is a group of symptoms caused by obstruction of the superior vena cava svc, a short, wide vessel carrying circulating blood into the heart. Svcs consists of symptoms and signs resulting from partial or complete obstruction of blood flow within the superior vena cava. Superior vena cava syndrome and otorrhagia during cardiac surgery. Introduction superior vena cava svc syndrome results from any condition that leads to obstruction of blood flow through the svc. Superior vena cava syndrome svcs, a clinical manifestation arising from compression of the thinwalled superior vena cava svc, was first described by william hunter in 1757 and can be caused by a variety malignancies hunter and johnston 1757. This obstruction is most commonly a result of thrombus formation or tumor infiltration of the vessel wall.
The superior vena cava svc is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. Sympathetic block and increased venous return from the left arm likely contributed to his airway obstruction that mimicked superior vena cava syndrome. Rodeada by rigid structures and compress the upper originate vena cava syndrome svcs. Superior vena cava svc syndrome is a collection of clinical signs and. A chest ct scan showed a persistent left superior vena cava draining into the coronary sinus, chronic thrombosis of the right superior vena cava and venous collateral circulation in the chest. Superior vena cava article about superior vena cava by the. Mar 27, 2020 superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. Bilyeu, md approximately 15,000 cases of superior vena cava svc obstruction are diagnosed in the united states annually.
Feb 29, 2016 superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. If this vein is compressed by outside structures, or if a thrombus or clot develops within it, return blood flow to the heart is impeded. Superior vena cava svc syndrome is a collection of clinical signs and symptoms resulting from either partial or complete obstruction of blood flow through the svc. Superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress. Outlaw march 9, 2004 svc syndrome constellation of signs and symptoms caused by obstruction of blood flow in the superior vena. Superior vena cava syndrome svcs includes various clinical signs and.
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