Endovascular strategies for superior vena cava obstruction

The symptoms of superior vena cava (SVC) obstruction can be extremely debilitating, and current medical and surgical treatments have been only partially successful in providing relief to afflicted patients. Endovascular techniques of venous recanalization have recently shown excellent short-term and mid-term success in patients with both benign and malignant causes of SVC obstruction. Endovascular therapy may be reasonably used as a first-line approach to the palliation of malignant SVC obstruction, and its mid-term patency rates compare favorably with those of modern surgical methods of venous bypass in patients with benign SVC obstruction. In this article, the percutaneous management: of SVC syndrome is discussed, with particular attention to the anatomical considerations and clinical priorities that impact endovascular decision making.