Behcet's syndrome is a multi-systemic and chronic disorder that affects many organs. It has been suggested that the diagnosis was based on the presence of the 'major' and 'minor' clinical criteria. When thromobophlebitis, arthritis, central nervous system or gastrointestinal lesions are also present. Behcet's syndrome will be thought to be present in the appropriate geographic area. We report a case of superior vena cava syndrome caused by Behcet's disease in a 40-year-old man with recurrent oral aphthous ulcers and skin rashes on the anterior chest wall. There were multiple thrombosis of the superior vena cava, innominate and subclavian veins. This patient also had a solitary cecal ulcer with an ileocecal fistula and downhill varix. The chest CT, veno-cavography, pulmonary angiography and colon study were taken and follow-up was performed.
Adult ; Behcet's Syndrome/diagnosis ; Behcet's Syndrome/complications* ; Cecal Diseases/complications ; Human ; Intestinal Fistula/complications ; Male ; Superior Vena Cava Syndrome/etiology* ; Superior Vena Cava Syndrome/diagnosis ; Ulcer/complications

Thrombosis is an important complication of central venous catheterization. Among the many intrinsic and extrinsic factors, the patient's medical disease can play a role in thrombogenesis. Behcet's disease (BD), classified as a vasculitis, is a multisystem disease involving the small blood vessels. It is often difficult to recognize and diagnose the disease. A 24-yr-old female patient showed massive central venous thrombosis which caused superior vena cava syndrome after subclavian vein catheterization. Twenty days after catheterization, the patient exhibited swelling of the face, neck, and both upper extremities. Despite thrombectomy and continuous anticoagulation therapy, her facial and upper extremity swelling reappeared and follow-up chest computed tomography (CT) showed the recurrent thrombosis in the same central veins previously affected. A diagnosis of BD was then made. Following steroid therapy, neither clinical symptoms nor CT findings suggestive of central venous thrombosis were observed during the subsequent 6-months of follow-up period. This case emphasizes that central venous catheterization in a patient with BD should be performed with great caution.
Adult ; Behcet's Syndrome/*complications ; Case Report ; Catheterization, Central Venous/*adverse effects ; Female ; Human ; Phlebography ; Superior Vena Cava Syndrome/diagnosis/*etiology ; Tomography, X-Ray Computed ; Vena Cava, Superior

No abstract available.
Aged ; Female ; Humans ; Liver Diseases/etiology/*radiography ; Superior Vena Cava Syndrome/*complications

We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.
Adult ; Brachiocephalic Veins ; Drainage ; Fibrosis ; Humans ; Hypertension ; Neurologic Manifestations ; Pericardium ; Postoperative Complications ; Superior Vena Cava Syndrome ; Transplants ; Veins ; Vena Cava, Superior* ; Venous Pressure

This paper introduced surgical treatment of malignancy-related superior vena cava syndrome. Typical cases were presented with diagnostic radiology results. Authors focused on the main approach to the malignancy-related superior vena cava syndrome of surgery. In order to make it simple for junior doctors to learn and practice, all 4 operation methods were described in details. The writer hopes it would be helpful for all the young thoracic surgeons.
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Humans ; Neoplasm Metastasis ; Superior Vena Cava Syndrome ; diagnostic imaging ; etiology ; surgery ; Thymoma ; complications ; diagnostic imaging ; surgery ; Thymus Neoplasms ; complications ; diagnostic imaging ; surgery ; Vena Cava, Superior ; diagnostic imaging ; pathology ; surgery

Arteriovenous Fistula ; complications ; diagnosis ; diagnostic imaging ; Child ; Contrast Media ; Coronary Angiography ; Coronary Vessels ; pathology ; Female ; Humans ; Superior Vena Cava Syndrome ; diagnosis ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Vena Cava, Superior ; abnormalities ; diagnostic imaging

Behcet's disease is a chronic multisystemic disorder involving many organs and characterized by recurrent oral and genital ulcers and relapsing iritis. A case of BD with large vein thrombosis involving superior and inferior vena cava is presented. Large vein thrombosis in BD is not commonly developed and most commonly observed in the inferior or superior vena cava. A review of the literature emphasizes the rarity of the combined superior and inferior vena caval occlusion. Existence of extensive large vein occlusion in BD is associated with limited therapy and poor prognosis.
Adult ; Behcet's Syndrome/diagnosis ; Behcet's Syndrome/complications* ; Disease Progression ; Fatal Outcome ; Female ; Fibrinolytic Agents/therapeutic use ; Human ; Phlebography ; Thrombosis/etiology* ; Thrombosis/drug therapy ; Thrombosis/diagnosis ; Vena Cava, Inferior/radiography* ; Vena Cava, Superior/radiography* ; Substances: Fibrinolytic Agents

Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.
*Collateral Circulation/physiology ; Female ; Humans ; Middle Aged ; Multidetector Computed Tomography ; Phlebography/methods ; Pulmonary Veins/physiopathology/*radiography ; Stroke/complications ; Superior Vena Cava Syndrome/physiopathology/*radiography ; Veins/physiopathology

To assess the effectiveness of endovascular stenting for the palliation of superior vena cava (SVC) syndrome, endovascular stent insertion was attempted in 10 patients with symptomatic occlusion of the SVC. All the patients had known malignant disease of the thorax. Eight patients had been treated previously with chemotherapy and radiotherapy (n=5), chemotherapy alone (n=2), or pneumonectomy and radiotherapy (n=1). After developing SVC syndrome, all the patients were stented before receiving any other treatment. After single or multiple endovascular stents were inserted, five of eight patients were treated with chemotherapy and radiotherapy (n=2) or chemotherapy alone (n=3). Resolution of symptoms was achieved in nine patients within 72 hr (90%). In one patient, the symptoms did not disappear until a second intervention. At follow up, symptoms had recurred in two of ten patients (20%) after intervals of 15 and 60 days. Five patients have died from their cancers, although they remained free of symptoms of SVC occlusion until death. In conclusion, endovascular stent insertion is an effective treatment for palliation of SVC syndrome. Endovascular stent insertion can be considered the first choice of treatment, due to the immediate relief of symptoms and excellent sustained symptomatic relief.
Adult ; Female ; Humans ; Male ; Middle Aged ; *Palliative Care ; Retrospective Studies ; *Stents ; Superior Vena Cava Syndrome/etiology/pathology/*therapy ; Thoracic Neoplasms/complications/pathology ; Treatment Outcome

OBJECTIVETo evaluate the effectiveness and safety of endovascular stent insertion for non-small cell lung cancer patients with superior vena cava syndrome.

METHODSWe retrospectively studied 123 patients referred to our hospital for the treatment of non-small cell lung cancer presenting with superior vena cava syndrome. Patients were devided in two groups according to the use of endovascular stent insertion in superior vena cava syndrome or not. 64 patients underwent endovascular stent insertion was designed as the stenting group and 59 without stenting as control group. The differences between the two groups in complete response, complication and survival were analyzed.

RESULTSThe complete response rate of superior vena cava obstruction was 92.0% for the stenting group, and 42.0% for the control group, showing a significant difference between the two groups (P < 0.001). The median time to complete response was (3.76 ± 2.83) days in the stenting group, significantly shorter than that of the control group (28.08 ± 16.06) days (P < 0.001). The relapse rate after complete response was 12.0% in the stenting group and 16.0% in the control group, showing a non-significant difference between the two groups (P = 0.607). The median time to relapse was 2.7 months in the stenting group and 1.1 months in the control group (P = 0.533). In the stenting group, stent stenosis occurred in 1 case and thrombosis was observed in 3 cases. The incidence rate of complications was 6.3%. Thrombosis occurred in 1 case of the control group, with an incidence rate of complications of 1.7%, showing a non-significant difference between the two groups (P = 0.201). Seven among the 123 patients were still alive at the endpoint of following up. The median survival time was 8.0 months (stenting group) and 5.5 months (control group) (P = 0.382).

CONCLUSIONSEndovascular stent insertion is effective and safe for non-small lung cell cancer patients with superior vena cava syndrome, and it may be recommended as the first choice for palliative treatment of superior vena cava obstruction.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; complications ; surgery ; Female ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Palliative Care ; Remission Induction ; Retrospective Studies ; Stents ; Superior Vena Cava Syndrome ; complications ; surgery ; Thrombosis