Tags

Type your tag names separated by a space and hit enter

Treatment of superior vena cava syndrome using AngioJet™ thrombectomy system.
CVIR Endovasc. 2019 Aug 14; 2(1):28.CE

Abstract

BACKGROUND

Superior vena cava syndrome is a relatively rare presentation in which diminished venous return to the heart produces congestion of the neck, face and upper extremities. Typically, a mediastinal mass produces external compression on the superior vena cava and reduces venous return. However, superior vena cava syndrome can present acutely in the setting of vena cava thrombosis. Multiple scoring systems are available to assist clinicians with appropriate timing of interventions for SVC syndrome. When specific criteria are met, endovascular intervention can be beneficial to patients to prevent rapid deterioration.

CASE PRESENTATION

A 75-year-old female with no significant past medical history presented to the emergency department with increased facial swelling, nausea and vomiting which began the night prior to presentation. The patient underwent a CT chest which revealed a 3.2 × 3.0 × 3.8 cm spiculated mass compressing the right main bronchus and right pulmonary artery. The patient was intubated and interventional radiology was consulted. The patient underwent venography which showed extensive thrombosis of the innominate veins. Rheolytic thrombectomy with AngioJet™ was performed to alleviate clot burden and minimize risk of secondary pulmonary embolism. Kissing stents were placed in the bilateral innominate veins to maintain patency after thrombectomy. After the procedure, the patient was successfully extubated and had near complete resolution of facial swelling approximately 12 h post procedure. A follow up venogram performed on post procedure day 4 showed patent bilateral subclavian, innominate, and internal jugular veins as well as a patent superior vena cava.

CONCLUSIONS

Acute occlusion of superior vena cava can present with life threatening symptoms such as loss of airway. AngioJet™ thrombectomy is another tool available to interventional radiologists when a patient's clinical condition necessitates treatment.

Authors+Show Affiliations

Zucker School of Medicine at Hofstra, Northwell at Staten Island University Hospital, Staten Island, NY, USA. aramjit@gmail.com.Zucker School of Medicine at Hofstra, Northwell at Staten Island University Hospital, Staten Island, NY, USA.Touro College, College of Osteopathic Medicine, New York, NY, USA.Zucker School of Medicine at Hofstra, Northwell at Staten Island University Hospital, Staten Island, NY, USA.Zucker School of Medicine at Hofstra, Northwell at Staten Island University Hospital, Staten Island, NY, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32026107

Citation

Ramjit, Amit, et al. "Treatment of Superior Vena Cava Syndrome Using AngioJet™ Thrombectomy System." CVIR Endovascular, vol. 2, no. 1, 2019, p. 28.
Ramjit A, Chen J, Konner M, et al. Treatment of superior vena cava syndrome using AngioJet™ thrombectomy system. CVIR Endovasc. 2019;2(1):28.
Ramjit, A., Chen, J., Konner, M., Landau, E., & Ahmad, N. (2019). Treatment of superior vena cava syndrome using AngioJet™ thrombectomy system. CVIR Endovascular, 2(1), 28. https://doi.org/10.1186/s42155-019-0071-3
Ramjit A, et al. Treatment of Superior Vena Cava Syndrome Using AngioJet™ Thrombectomy System. CVIR Endovasc. 2019 Aug 14;2(1):28. PubMed PMID: 32026107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of superior vena cava syndrome using AngioJet™ thrombectomy system. AU - Ramjit,Amit, AU - Chen,Jesse, AU - Konner,Marcus, AU - Landau,Elliot, AU - Ahmad,Noor, Y1 - 2019/08/14/ PY - 2019/03/21/received PY - 2019/08/06/accepted PY - 2020/2/7/entrez PY - 2020/2/7/pubmed PY - 2020/2/7/medline KW - AngioJet KW - Rheolytic Thrombectomy KW - SVC syndrome SP - 28 EP - 28 JF - CVIR endovascular JO - CVIR Endovasc VL - 2 IS - 1 N2 - BACKGROUND: Superior vena cava syndrome is a relatively rare presentation in which diminished venous return to the heart produces congestion of the neck, face and upper extremities. Typically, a mediastinal mass produces external compression on the superior vena cava and reduces venous return. However, superior vena cava syndrome can present acutely in the setting of vena cava thrombosis. Multiple scoring systems are available to assist clinicians with appropriate timing of interventions for SVC syndrome. When specific criteria are met, endovascular intervention can be beneficial to patients to prevent rapid deterioration. CASE PRESENTATION: A 75-year-old female with no significant past medical history presented to the emergency department with increased facial swelling, nausea and vomiting which began the night prior to presentation. The patient underwent a CT chest which revealed a 3.2 × 3.0 × 3.8 cm spiculated mass compressing the right main bronchus and right pulmonary artery. The patient was intubated and interventional radiology was consulted. The patient underwent venography which showed extensive thrombosis of the innominate veins. Rheolytic thrombectomy with AngioJet™ was performed to alleviate clot burden and minimize risk of secondary pulmonary embolism. Kissing stents were placed in the bilateral innominate veins to maintain patency after thrombectomy. After the procedure, the patient was successfully extubated and had near complete resolution of facial swelling approximately 12 h post procedure. A follow up venogram performed on post procedure day 4 showed patent bilateral subclavian, innominate, and internal jugular veins as well as a patent superior vena cava. CONCLUSIONS: Acute occlusion of superior vena cava can present with life threatening symptoms such as loss of airway. AngioJet™ thrombectomy is another tool available to interventional radiologists when a patient's clinical condition necessitates treatment. SN - 2520-8934 UR - https://www.unboundmedicine.com/medline/citation/32026107/Treatment_of_superior_vena_cava_syndrome_using_AngioJet™_thrombectomy_system L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32026107/ DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.