Efficiency of endovascular stenting in the treatment of malignancy related vena cava superior syndrome: single center experience

Yıl 2018, Cilt: 10 Sayı: 4, 449 - 453, 01.12.2018

Ali Ayberk Beşen

https://doi.org/10.21601/ortadogutipdergisi.457666

Öz

Aim: To
evaluate efficacy of the endovascular stenting for symptomatic treatment of
malignancy-related vena cava superior (VCS) syndrome.

Material and Method: Thirty-five
patients who underwent endovascular stenting at Baskent University between
December 2005 and October 2016 due to malign VCS were evaluated retrospectively.

Results: A
total of 54 stenting procedures were performed in 35 patients. 48% of the
patients had a single stent and 43% had two stents. Of the patients on
stenting, 6 were women and 29 were men. 68% of all patients were stage 4, and
77% were patients with lung cancer. Symptomatic relief was observed in 31 (89%)
patients after the procedure. Re-stenting was performed in four patients for
stent thrombosis and in two patients for tumor ingrowth. After stenting, 23 patients
were given anti-coagulant treatment. Median overall survival (OS) was 20 weeks
(range, 6.5-33.4) in the whole group. In patients with lung cancer, OS after
stenting was found to be numerically shorter than other groups, but it did not
reach statistical significance.

Conclusion: Endovascular stenting in the palliative treatment of
malignancy-related SVC syndrome is an effective treatment method with high
clinical success and low morbidity both in newly diagnosed patients and in
patients on progression.

Anahtar Kelimeler

Vena cava superior syndrome, stent, lung cancer

Malignite ilişkili vena kava superior sendromunun tedavisinde stent uygulanmasının etkinliği: tek merkez deneyimi

Öz

Amaç: Malignite ilişkili
vena kava superior (VKS) sendromunun semptomatik tedavisinde endovasküler stent
uygulanan hastalarda bu yaklaşımın etkinliğini değerlendirmeyi amaçladık.

Gereç ve Yöntem: Malign VKS sendromu
nedeniyle Başkent Üniversitesinde Aralık 2005- Ekim 2016 tarihleri arasında
endovasküler stent uygulanan 35 hasta retrospektif olarak incelenmiştir.

Bulgular: 35 hastaya toplam 54
stent işlemi gerçekleştirilmiştir.
Hastaların %48’ine tek stent %43’üne ise iki stent konulmuştur. Stent uygulanan
hastaların 6’sı kadın 29’u ise erkekti. Tüm hastaların %68’ini evre 4, %77’sini akciğer
kanserli hastalar oluşturmuştur. İşlem sonrası 31 (%89) hastada semptomatik
rahatlama gözlenmiştir. Hastaların takibinde 4 hastada stent trombozu 2 hastada
ise tümör basısı nedeni ile re-stent ihtiyacı olmuştur. Stent sonrası 23
hastaya anti-koagülan tedavi verilmiştir. Tüm grupta ortanca genel sağkalım
(GSK) 20 hafta (aralık 6,5-33,4 ) olarak bulunmuştur. Stent sonrası akciğer
kanserli hastalarda GSK diğer gruplara göre sayısal olarak daha kısa olarak
bulunmuş ancak istatistiksel anlamlılığa ulaşmamıştır.

Sonuç: Malignite ilişkili SVK
sendromunun palyatif tedavisinde endovasküler stent uygulanması tanı anında ya
da progresif hastalık durumunda yüksek klinik başarı ve düşük morbidite ile
etkin bir tedavi yöntemidir. 

Anahtar Kelimeler

Vena kava superior sendromu, stent, akciğer kanseri

Kaynakça

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