Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement
A 73-year-old male patient was admitted to the emergency department with dyspnea and severe edema in the lower extremities. The patient had been diagnosed with extensive small-cell lung cancer 15 months previously. Contrast-enhanced CT revealed suprahepatic compression of the inferior vena cava (IVC...
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Elsevier
2025-07-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043325002663 |
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| author | Manos Siderakis, MD, BSc, MSc Georgia Papavasileiou, MD, MSc Margarita Moutou, MD, MSc George Gkeneralis, MD, MSc, PhD Viktoria Kartsouni, MD, MSc, PhD Myrsini Gkeli, MD, MSc |
| author_facet | Manos Siderakis, MD, BSc, MSc Georgia Papavasileiou, MD, MSc Margarita Moutou, MD, MSc George Gkeneralis, MD, MSc, PhD Viktoria Kartsouni, MD, MSc, PhD Myrsini Gkeli, MD, MSc |
| author_sort | Manos Siderakis, MD, BSc, MSc |
| collection | DOAJ |
| description | A 73-year-old male patient was admitted to the emergency department with dyspnea and severe edema in the lower extremities. The patient had been diagnosed with extensive small-cell lung cancer 15 months previously. Contrast-enhanced CT revealed suprahepatic compression of the inferior vena cava (IVC) at the level of its entry into the right atrium, caused by a space-occupying, infiltrating right lung lesion. Inferior vena cava syndrome (IVCS) occurs after obstruction of venous flow through the IVC. Trunk and lower limb edema are the most common manifestations of this syndrome, whereas cardiac function may be compromised in more severe cases. Given the patient's performance status, disease stage, and symptom acuity, endovascular stenting of the IVC was preferred over surgery or radiotherapy. The superior vena cava (SVC)-to-IVC bridging stent approach was employed to address the severe mass effect and location of the IVC stenosis at its junction with the right atrium. Three uncovered self-expandable stents were deployed in tandem from the SVC to the IVC. Overlap between stents minimized the risk of collapse within the right atrium, possibly leading to cardiac conduction disorders or even perforation of the heart wall. The patient experienced alleviation of IVCS symptoms over the next 48 h but unfortunately passed away 8 days later from his primary disease. Although primarily palliative in oncologic cases, SVC-to-IVC stenting can offer rapid and safe relief of symptoms in patients with advanced oncologic disease by restoring venous return to the heart. |
| format | Article |
| id | doaj-art-543ddb7b22394ba192e336ea2b595751 |
| institution | Kabale University |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-543ddb7b22394ba192e336ea2b5957512025-08-20T03:49:42ZengElsevierRadiology Case Reports1930-04332025-07-012073211321510.1016/j.radcr.2025.03.059Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placementManos Siderakis, MD, BSc, MSc0Georgia Papavasileiou, MD, MSc1Margarita Moutou, MD, MSc2George Gkeneralis, MD, MSc, PhD3Viktoria Kartsouni, MD, MSc, PhD4Myrsini Gkeli, MD, MSc5Corresponding author.; Interventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceInterventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceInterventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceInterventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceInterventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceInterventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras avenue 171, Athens 11522, GreeceA 73-year-old male patient was admitted to the emergency department with dyspnea and severe edema in the lower extremities. The patient had been diagnosed with extensive small-cell lung cancer 15 months previously. Contrast-enhanced CT revealed suprahepatic compression of the inferior vena cava (IVC) at the level of its entry into the right atrium, caused by a space-occupying, infiltrating right lung lesion. Inferior vena cava syndrome (IVCS) occurs after obstruction of venous flow through the IVC. Trunk and lower limb edema are the most common manifestations of this syndrome, whereas cardiac function may be compromised in more severe cases. Given the patient's performance status, disease stage, and symptom acuity, endovascular stenting of the IVC was preferred over surgery or radiotherapy. The superior vena cava (SVC)-to-IVC bridging stent approach was employed to address the severe mass effect and location of the IVC stenosis at its junction with the right atrium. Three uncovered self-expandable stents were deployed in tandem from the SVC to the IVC. Overlap between stents minimized the risk of collapse within the right atrium, possibly leading to cardiac conduction disorders or even perforation of the heart wall. The patient experienced alleviation of IVCS symptoms over the next 48 h but unfortunately passed away 8 days later from his primary disease. Although primarily palliative in oncologic cases, SVC-to-IVC stenting can offer rapid and safe relief of symptoms in patients with advanced oncologic disease by restoring venous return to the heart.http://www.sciencedirect.com/science/article/pii/S1930043325002663Inferior vena cava syndromeStentingBridging |
| spellingShingle | Manos Siderakis, MD, BSc, MSc Georgia Papavasileiou, MD, MSc Margarita Moutou, MD, MSc George Gkeneralis, MD, MSc, PhD Viktoria Kartsouni, MD, MSc, PhD Myrsini Gkeli, MD, MSc Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement Radiology Case Reports Inferior vena cava syndrome Stenting Bridging |
| title | Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement |
| title_full | Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement |
| title_fullStr | Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement |
| title_full_unstemmed | Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement |
| title_short | Management of malignant inferior vena cava syndrome (IVCS) by endovascular bridging stent placement |
| title_sort | management of malignant inferior vena cava syndrome ivcs by endovascular bridging stent placement |
| topic | Inferior vena cava syndrome Stenting Bridging |
| url | http://www.sciencedirect.com/science/article/pii/S1930043325002663 |
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