It is important to remember that patients with SVC syndrome are at increased risk for recurrent DVT and pulmonary embolism and, therefore, should receive anticoagulation after either successful or unsuccessful thrombolytic therapy. Likewise, with symptom resolution and catheter preservation after thrombolytic therapy, anticoagulation should be maintained as long as the…
To our knowledge, this series is the largest published to date, Table 6 shows all of the cases in the English literature in which thrombolysis was used to treat SVC syndrome. It is interesting to note that there was 100 percent success in every case reported thus far aside from…
Cost was not a deciding factor in the use of a particular agent since the overall cost has been demonstrated to be equivalent when complications and hospital stay are taken into consideration. Urokinase was chosen because of superior results in the treatment of DVT, pulmonary embolism, and peripheral arterial occlusion…
Between two and five days, the success rate dropped to 65 percent; six to nine days showed a marked drop to 33 percent; and after ten days, no successful thrombolysis occurred. Maximal rates of thrombolysis occur with newly formed thrombi. These data may be somewhat misleading, since arterial occlusions can…
Patients without indwelling venous catheters did not have as high a lysis rate as those with an indwelling catheter because of the following reasons: (1) the thrombus was recognized later because there was no catheter malfunction to give warning; (2) there often was external compression on the SVC and therefore…
Eleven patients in this series had central venous catheters that were considered to be contributing factors in the development of SVC syndrome. This subpopulation was more likely to have thrombosis as a cause of SVC syndrome, whereas obstruction, fibrosis, or compression was the major cause of SVC syndrome in the…
Traditionally, SVC syndrome has been considered a medical emergency. Lolach and Goodman found that 97 percent of their patients with SVC syndrome had underlying cancer as a cause and recommended that radiation therapy be instituted early without subjecting the patient to unnecessary diagnostic tests. They also suggested that anticoagulants and…