Superior vena cava syndrome

  The upper part of the body including the head, neck, upper chest and bilateral upper limbs of venous blood return to the heart through the superior vena cava, and the series of clinical symptoms caused by the narrowing or occlusion of the superior vena cava is called superior vena cava syndrome, which is the most common clinical emergency of tumor. It can lead to conjunctival edema, intracranial pressure elevation, headache, blurred vision and impaired consciousness, and can be life-threatening in severe cases.  Common tumors causing superior vena cava syndrome include lung cancer, breast cancer metastases, and mediastinal tumors such as lymphoma, thymoma, and germ cell tumors. Rare non-tumor causes include mediastinitis, goiter, tuberculosis, post-operative central venous cannulation or pacemaker placement, and thrombosis.  The first step in the treatment of superior vena cava syndrome is to relieve venous obstruction and provide timely relief of symptoms, and the second step is to treat the cause, including tumors. The most rapid and effective treatment for venous obstruction is vascular intervention, such as the placement of superior vena cava stents for malignant tumors, balloon dilation for venous stenosis caused by benign lesions, and intubation and anticoagulation for acute thrombosis. The main treatment for tumor etiology is radiotherapy and chemotherapy, but they are generally effective only for small cell lung cancer, lymphoma, and germ cell tumors, and the onset of action usually takes several weeks.  Interventional treatment of superior vena cava syndrome is usually performed through a superficial vein puncture in the femoral vein or upper extremity under local anesthesia, which is less painful and has a high safety and success rate. The results of successful treatment are immediate.