Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492006000400011
Jornal Vascular Brasileiro
Relato de Caso

Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura

Endovascular treatment of superior vena cava syndrome: case report and review of the literature

Marco Aurélio Cardozo; Eduardo Lichtenfels; Nilon Erling Jr.; Dorvaldo P. Tarasconi

http://dx.doi.org/10.1590/S1677-54492006000400011 J Vasc Bras, vol.5, n4, p.308-312, 2006
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Resumo

Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior.

Palavras-chave

Angioplastia, veia cava, estenose

Abstract

We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the right brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

Keywords

Angioplasty, vena cava, stenosis

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