Superior Vena Cava Syndrome: An Update and Literature Review of Percutaneous Endovascular Treatments

Superior vena cava syndrome (SVCS) is a spectrum of symp-toms resulting from the obstruction of the easily compress-ible SVC, due to either external compression from the mediastinal structures or internal narrowing of the vessel. SVCS was first described in 1757 by famed anatomist Sir William Hunter.1 Malignant causes are the main etiology of SVCS, ranging from 70 to 85% of cases, predominantly due to lung cancer.2,3 Historically, infectious conditions such as granulomatous mediastinitis secondary to tuberculosis and syphilitic aortic aneurysm were the predominant causes; however, this has shifted due to antibiotic treatment and increased utility of central venous catheters and endovas-cular cardiac leads.4 There is a paucity of guidelines and randomized trials to guide the clinical practice, and SVCS is treated on an individual basis, taking into account the etiology, severity of symptoms, and disease prognosis.5 Endovascular therapy is considered the first-line treatment for the emergent and benign cases of SVCS, and can be a well-tolerated treatment for long-term symptomatic relief, in conjunction with other therapies.