Long-term Patency of Venous Stent After Sharp Recanalization for Benign Superior Vena Cava Occlusion.
Ryosuke Shima, Masashi Fujimori, Takashi Yamanaka et al.
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Case in brief
A man in his 50s with short-bowel syndrome developed facial and upper-extremity edema from benign superior vena cava syndrome after repeated central venous catheter placement. Venography showed complete SVC occlusion (modified Stanford type 4). Under biplane fluoroscopy and cone-beam CT guidance, operators used a trans-septal needle for sharp recanalization and placed a 14 × 40 mm self-expanding bare-metal stent. Symptoms resolved the next day. In-stent restenosis at 10 months was treated with balloon dilatation; the stent then remained patent, with no recurrent SVCS, for 10 years of follow-up.
What made this case unusual
The report documents 10-year stent patency after sharp recanalization of a completely occluded benign SVC, following one re-intervention for restenosis.
Diagnostic / clinical pearl
In this case, image-guided sharp recanalization enabled stent placement despite complete benign SVC occlusion; restenosis was managed with balloon dilatation.