Format

Send to

Choose Destination
Am J Surg. 1993 Aug;166(2):200-4; discussion 204-5.

Comparison of operative reconstruction and percutaneous balloon dilatation for central venous obstruction.

Author information

1
Department of Surgery, Ochsner Clinic, New Orleans, Louisiana 70121.

Abstract

To evaluate the efficacy of venous reconstruction versus percutaneous transluminal angioplasty for the treatment of obstruction of the superior vena cava and its major tributaries, we retrospectively reviewed the clinical course of 27 patients, of whom 13 underwent operative reconstruction and 15 had angioplasty (1 had both). Three patients had obstruction of the superior vena cava, 8 had occlusion of the innominate veins, and 16 had obstruction of the subclavian or axillary veins. In both treatment groups, mean age, indications, etiology, and location of the lesion were comparable. No major surgical complications occurred; one patient who underwent angioplasty experienced stent migration to the pulmonary artery without sequelae. Primary symptomatic relief at 1 year was achieved in 88% in the surgical group versus 36% in the angioplasty group (p < 0.05 by Fisher's exact test) and at 2 years in 71% versus 0%, respectively (p < 0.01). One- and 2-year success rates with repeated angioplasty, however, were 86% and 66% (p > 0.9), respectively. We conclude that the long-term success rate of operative reconstruction exceeds that of single percutaneous transluminal angioplasty. However, with repeated angioplasty, success rates approach those of operative reconstruction.

PMID:
8352416
DOI:
10.1016/s0002-9610(05)81056-6
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center