Catheter-directed thrombectomy combined with angioplasty and stent implantation for superior vena cava syndrome: a case report

作者：Hao Wang, Zi-Yi Liu, Chang-Yuan Liu, Guang-Sheng Zhao, Shunxiong Tang, Jun-Jie Qu, Fang Xu, Jun Zhou · 发表于：Translational Cancer Research · 年份：2025 · DOI：10.21037/tcr-2025-aw-2492 · 研究领域：Central Venous Catheters and Hemodialysis、Vascular anomalies and interventions、Venous Thromboembolism Diagnosis and Management

Background: Superior vena cava (SVC) syndrome (SVCS) caused by thrombosis in artificial vascular grafts is characterized by high morbidity and mortality, with endovascular treatment being the primary therapeutic approach. In this case report, we present a safe multimodal endovascular treatment protocol that can rapidly alleviate acute SVCS symptoms, combining targeted thrombectomy via a guiding catheter with balloon dilation and Bard venous stent placement. Such combined endovascular therapies remain relatively uncommon in clinical reports. Case Description: A 61-year-old female with a 10-year history of mediastinal nodules was admitted to hospital for recurrent dizziness. Via computed tomography (CT), she was diagnosed with a malignant thymic tumor invading the SVC and subsequently underwent sternotomy via a video-assisted thoracoscopic approach for tumor resection and SVC reconstruction with an 8-mm expanded polytetrafluoroethylene (e-PTFE) graft. Postoperatively, she developed SVCS (upper extremity/chest wall swelling, cyanosis) due to graft occlusion. Emergency treatment included 8F guiding catheter thrombectomy, sequential balloon dilatation, and Bard venous stenting, which resolved the stenosis. She received anticoagulants (low-molecular-weight heparin and subsequent rivaroxaban) and had no thrombosis at follow-up in August 2024. Conclusions: The combination of guiding catheter thrombectomy, balloon dilatation, and Bard stent implantation is feasible, safe, and effectiv...