Is Long-Term Anticoagulation Required after Stent Placement for Benign Superior Vena Cava Syndrome?
| Autor: | James C. Andrews, Mustafa M. Haddad, Emily C. Bendel, Manju Kalra, Newton B. Neidert, Sanjay Misra, Ian R. McPhail, Haraldur Bjarnason, Melissa J. Neisen, Scott M. Thompson, Andrew H. Stockland |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Superior Vena Cava Syndrome medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Drug Administration Schedule 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences 0302 clinical medicine Symptom relief Risk Factors Superior vena cava Humans Medicine Radiology Nuclear Medicine and imaging In patient Aged Aged 80 and over Superior vena cava syndrome business.industry Endovascular Procedures Significant difference Percent stenosis Anticoagulants Stent Thrombosis Middle Aged Surgery Stent placement Treatment Outcome Female Stents medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular and Interventional Radiology. 29:1741-1747 |
| ISSN: | 1051-0443 |
| DOI: | 10.1016/j.jvir.2018.07.020 |
| Popis: | Purpose To identify whether symptom relief and stent patency vary with use of long-term anticoagulation after stent placement for benign superior vena cava (SVC) syndrome. Materials and Methods Patients with benign SVC syndrome treated with stent placement between January 1999 and July 2017 were retrospectively identified (n = 58). Average age was 49 years (range, 24–80 y); 34 (58%) were women, and 24 (42%) were men. Average follow-up was 2.4 years (range, 0.1–11.1 y, SD 2.6). Of cases, 37 (64%) were due to a long-term line/pacemaker, and 21 (36%) were due to fibrosing mediastinitis. After stent placement, 36 (62%) patients were placed on long-term anticoagulation, and 22 (38%) were not placed on anticoagulation. Percent stenosis was evaluated on follow-up imaging by dividing smallest diameter of the stent by a normal nonstenotic segment of the stent and multiplying by 100. Results Technical success was achieved in all cases. There was no significant difference in number of patients who reported a return of symptoms characteristic of benign SVC syndrome between the anticoagulated (16 of 36; 44.4%) and nonanticoagulated (11 of 22; 50%) groups (P = .68). There was no significant difference in the mean percent stenosis between the anticoagulated (40.4% ± 34.7% [range, 0–100%]) and nonanticoagulated (32.1% ± 29.2% [range, 1.7%–100%]) groups (P = .36). No significant difference was found in the time (days) between date of procedure and date of return of symptoms (anticoagulated, 735.9 d ± 1,003.1 [range, 23–3,851 d]; nonanticoagulated, 478 d ± 826.6 [range, 28–2,922 d]) (P = .49). There was no difference in primary patency between groups (P = .59). Finally, 1 patient (2.8%) in the anticoagulated group required surgical intervention, whereas none in the nonanticoagulated group required surgical intervention. Conclusions No significant difference was observed in clinical and treatment outcomes in patients who did and did not receive anticoagulation after stent placement for benign SVC syndrome. Management of benign SVC syndrome after stent placement may not require anticoagulation if confirmed by additional studies. |
| Databáze: | OpenAIRE |
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