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Endovascular treatment of superior vena cava syndrome utilizing an iliac branch endoprosthesis

Year: 2025

Type: article

Abstract: Endovascular therapy is the preferred treatment for superior vena cava (SVC) syndrome, providing rapid symptom relief and high technical success. Lesions involving the confluence of the bilateral innominate veins and SVC, however, remain challenging due to complex anatomy and limited durability of standard stents. This case series describes the off-label use of the Gore Iliac Branch Endoprosthesis (IBE) for reconstruction of the SVC confluence in four patients with SVC syndrome: three with malignant etiologies and one with benign catheter-associated thrombosis. Technical success was achieved in all patients, with immediate restoration of venous flow and symptom resolution. In malignant cases, patency was maintained until death from cancer at 5–20 months. The benign case demonstrated durable patency and complete symptom relief at 18-month follow-up. No procedural complications or early device failures occurred. The Gore IBE offers a feasible approach for anatomic reconstruction of the SVC confluence, accommodating bilateral venous inflow while maintaining luminal integrity. This technique may overcome limitations of parallel stenting, providing durable symptom relief in both malignant and benign SVC syndrome. Further investigation is warranted to evaluate long-term outcomes and broader applicability.

Source: Annals of Vascular Surgery - Brief Reports and Innovations

DOI: 10.1016/j.avsurg.2025.100416

Authors: Carter Colwell, Bernard Boateng, Marisa Doran, Cole Pieroni, Esmaeel Dadashzadeh, Joshua D. Adams

Institutions: Carilion Clinic, Virginia Tech

Language: English

Topic: Vascular anomalies and interventions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,490