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 endovascular stenting to treat obstruction of the superior vena cava

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

A 59 year old woman with a history of recurrent left sided breast cancer presented in October 2004 with bilateral arm and neck swelling, increasing shortness of breath, and headaches. We made a working diagnosis of obstruction of the superior vena cava. She had undergone surgery and external beam radiotherapy 13 years before for primary breast cancer. She subsequently underwent left mastectomy and chemotherapy for reoccurrence in 2000.

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


Signs
Dilatation of the neck, arm, and chest wall veins
Oedema of the upper body, extremities, and face

Symptoms

Cough and haemoptysis
Dysphagia
Chest pain
Dyspnoea

Signs

Severe respiratory distress
Cyanosis
Engorged conjunctiva
Convulsions and coma

Symptoms

Severe headache and feelings of "tension in the head"—worse in the morning . . . [Full text of this article]



Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?



Access jobs at BMJ Careers
Whats new online at Student 

BMJ