Uperior vena cava syndrome (svcs) was first described in l757 in a patient with a syphilitic

Thrombolytic Therapy

The role of thrombolytic therapy and subsequent

anticoagulation for SVCS has become increasingly

important within the past decade. Pericatheter throm-

bosis has been demonstrated by venography in approx-

imately 50% of non-anticoagulated patients with long-

term central venous catheters. Depending on the

acuteness or chronicity of the thrombosis, thrombolyt-

ic therapy can be used. In patients with an acute occur-

rence, thrombolytic therapy can achieve excellent

results.

1

Anticoagulation

Patients with SVCS are at increased risk for deep

vein thrombosis and pulmonary embolism. In patients

for whom thrombosis is the cause of SVCS, anticoagu-

lation therapy should be administered after successful

thrombolytic treatment. Once the symptoms subside

after thrombolytic therapy, anticoagulation should be

maintained as long as the central venous catheter is

present. Recently, low dose warfarin has been noted to

significantly decrease thrombosis in patients with cen-

tral venous catheters.

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B h i m j i   :   S u p e r i o r   V e n a   C a v a   S y n d r o m e   :   p p .   4 2 – 4 6 ,   6 3