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

Other Treatment Options

Additional measures used to treat SVCS include the

administration of steroids or diuretic agents and salt

restriction. Diuretic agents may provide symptomatic

relief of edema; this relief is often immediate but not

long term. Steroids are useful in the presence of respi-

ratory compromise but the long-term use of steroids

may be considered harmful because of significant side

effects.

PROGNOSIS

The prognosis of SVCS depends on the underlying

obstruction. Malignancies of the mediastinum are the

most common cause of SVCS today, and the overall

prognosis for these patients is poor. In past studies, the

average survival time for patients with SVCS caused by

malignancies of the mediastinum has been approxi-

mately 6 to 9 months. Most patients with SVCS can be

successfully managed with medical or radiation thera-

py. For patients with severe unrelenting symptoms

caused by malignant disease, thrombolysis, balloon

angioplasty, and stenting appear to be clinically accept-

able forms of therapy. Surgical bypass is primarily re-

served for the few patients with persistent symptoms of

SVCS secondary to a benign pathology.