Page 57 - Virtual Vascular Vol 6

Malignant SVC Obstruction

xternal compression by mediastinal malignant tumors or
Elymph nodes is another cause of SUPERIOR VENA CAVA
OBSTRUCTION. This 72 year old lady has a large bronchogenic
carcinoma obstructing the R main bronchus leading to col- Central airway obstruction,
lapse of her right lung. Her SVC, and the two brachiocephalic severe laryngeal edema,
veins were compressed by the tumor. coma from cerebral edema
are medical emergencies.

Patients frequently complain of facial swelling, which may be
exacerbated by bending forward or lying down, or arm swell- Endovascular treatment
ing. Edema can narrow the lumen of the nasal passages and with stenting in the SVC
larynx, potentially compromising the function of the larynx or may provide symptomatic
pharynx and causing dyspnea, stridor, cough, hoarseness, and relief.
dysphagia. Patients with cerebral edema may have head-
aches, confusion, or visual/auditory disturbances.
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