Interventionelle Behandlung des akuten und subakuten Vena-cava-superior-Syndroms

Zusammenfassung

Hintergrund: Infolge eines fehlenden zentralvenösen Abflusses über die obere Hohlvene kann das Vena-cava-superior-Syndrom (VCSS) eine lebensgefährliche Situation darstellen. Ein schnelles und effektives Therapiekonzept ist entscheidend.

Methode: Anhand von zwei Fallberichten wird die endovaskuläre Stenttherapie zur Behandlung des akuten und subakuten VCSS erläutert und diskutiert.

Ergebnisse: Im ersten Fall berichten wir über einen Patienten mit akuter Dyspnoe durch eine obere Einflussstauung bei Dekompensation einer chronischen Thrombose der Vena cava superior. Im zweiten Fall mit gleicher Akutsymptomatik lag eine tumorbedingte Kompression der Vena cava superior vor. Die Akutsituation der VCSS konnte bei beiden Patienten mittels Stentimplantation therapiert werden.

Schlussfolgerung: Die endovaskuläre Therapie des akuten VCSS stellt eine effektive Therapieoption dar.

Abstract

Background: Superior vena cava syndrome is defined as the lack of central venous inflow through the superior vena cava and can present a life-threatening situation. The acute situation is characterized by dyspnea and requires a fast and effective treatment.

Methods: Using two case reports, endovascular stent therapy for the treatment of acute and subacute superior vena cava syndrome is explained and discussed.

Results: In the first case, we introduce a patient with acute dyspnea due to decompensation of a chronic thrombosis of the superior vena cava. The second case displayed the same acute symptoms consisting of acute dyspnea and upper venous congestion due to a tumor-related compression of the superior vena cava. In both cases, the acute situation of superior vena cava syndrome was successfully treated by stent implantation.

Conclusion: Endovascular treatment of superior vena cava syndrome is an effective option with a high technical success rate.

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