Diagnostisches und therapeutisches management der oberen einflussstauung

Translated title of the contribution: Diagnostic and therapeutic management of superior vena cava syndrome

Wolfram Dempke, Curt Behrmann, Christoph Schöber, Thomas Büchele, Axel Grothey, Hans Joachim Schmoll

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background: Superior vena cava syndrome (SVCS) is the clinical expression of obstruction of blood flow through the superior caval vein. In more than 80% of patients this complication is due to a malignant tumor, and in 60% of cases the first symptom of this tumor. Diagnosis and Treatment: If the clinical course of SVCS represents an absolute emergency, irradiation may have to be started immediately, even before the histologic diagnosis is established. Alternatively, expandable metallic stents have been used with considerable success for treatment of vena caval obstruction since patients respond immediately after stent implantation. For diagnosis, a chest X-ray and a CT scan should be performed. Chemotherapy is the treatment of choice for high-grade lymphomas, germ cell tumors and small-cell lung cancer since this modality is more effective than radiotherapy (response rate: 80%). For less chemotherapy responsive tumors radiotherapy is the primary treatment. Successful experience with thrombolytic agents is limited to treatment of catheter-induced SVCS, in contrast, only 20% of patients respond to thrombolytic therapy in the absence of a central catheter. Surgical resection of SVCS associated tumors has not improved survival rates and should be avoided.

Translated title of the contributionDiagnostic and therapeutic management of superior vena cava syndrome
Original languageGerman
Pages (from-to)681-684
Number of pages4
JournalMedizinische Klinik
Volume94
Issue number12
DOIs
StatePublished - Dec 15 1999

Keywords

  • Diagnostic procedures
  • Therapeutic management
  • Vena cava superior syndrome

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Dempke, W., Behrmann, C., Schöber, C., Büchele, T., Grothey, A., & Schmoll, H. J. (1999). Diagnostisches und therapeutisches management der oberen einflussstauung. Medizinische Klinik, 94(12), 681-684. https://doi.org/10.1007/BF03044758