Endovascular stenting to treat obstruction of the superior vena cava

doi:10.1136/bmj.39562.512789.80

BMJ 2008;336:1434-1437 (21 June), doi:10.1136/bmj.39562.512789.80

Practice

Rational Imaging

Endovascular stenting to treat obstruction of the superior vena cava

Anthony F Watkinson, professor of radiology¹, Tow Non Yeow, specialist registrar radiology ², Clementine Fraser, fourth year medical student ¹

¹ Peninsula Medical School, Royal Devon and Exeter Hospital, Exeter EX2 5DW , ² Royal Devon and Exeter Hospital, Exeter EX2 5DW

Correspondence to: A F Watkinson anthony.watkinson@rdeft.nhs.uk

This article discusses the use of image guided endovascularstenting to treat obstruction of the superior vena cava

The first 150 words of the full text of this article appear below.

The patient

A 59 year old woman with a history of recurrent left sided breastcancer presented in October 2004 with bilateral arm and neckswelling, increasing shortness of breath, and headaches. Wemade a working diagnosis of obstruction of the superior venacava. She had undergone surgery and external beam radiotherapy13 years before for primary breast cancer. She subsequentlyunderwent left mastectomy and chemotherapy for reoccurrencein 2000.

What is the next investigation?

Superior vena cava obstruction is usually diagnosed clinically,with the patient presenting with signs and symptoms relatedto venous congestion (box 1). Chest radiography usually demonstratesthe abnormality with a widened mediastinum, although this maybe normal.¹