ABSTRACT
We describe three cases of acute pericardial effusion during endovascular treatment
of superior vena cava (SVC) syndrome, one of which resulted in fatal pericardial tamponade.
SVC syndrome results from impaired venous return from the head and upper extremities
to the right atrium. Malignancy and catheter-induced SVC stenosis accounts for the
majority of cases of SVC syndrome. Endovascular therapy is the treatment of choice
for SVC syndrome due to its rapid relief of symptoms and low morbidity. Acute pericardial
effusion and pericardial tamponade may result from inadvertent extraluminal traversal
of the SVC in the so-called danger zone above the right atrium, as well as secondary
to dissection of wires in a location where fascial planes have been altered by neoplasia
or inflammation.
KEYWORDS
Superior vena cava syndrome - pericardial effusion - pericardial tamponade - angioplasty
complication
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Susan K O'HoroM.D. M.P.H.
Instructor, Department of Radiology, Division of Interventional Radiology
Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115