Radiology, Vol 195, 147-152, Copyright © 1995 by Radiological Society of North America
Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome
S Furui, S Sawada, K Kuramoto, Y Inoue, T Irie, K Makita, T Yamauchi, K Tsuchiya and S Kusano
Department of Radiology, National Defense Medical College, Saitama, Japan.
PURPOSE: To determine the factors that may be used to predict outcome of
stent placement in patients with malignancies obstructing the superior or
inferior vena cava. MATERIALS AND METHODS: Gianturco stents were placed in
39 patients with malignant obstruction of the superior (n = 16) or inferior
(n = 23) vena cava. Thirteen patients with obstruction of the superior vena
cava received radiation therapy and/or chemotherapy at some time in their
course of treatment. Computed tomographic (CT) scans were obtained in all
patients. The authors analyzed treatment outcome with the location, length,
and CT appearance of obstruction. RESULTS: Venous congestive symptoms
disappeared after stent placement in 35 patients and remained in four.
Symptoms did not recur during 1-13-month follow-up in 32 of the 35 patients
in whom the symptoms disappeared. Nonfatal complications were observed in
nine patients. Results of multivariate analysis showed that the outcome of
stent placement is best predicted by the appearance of obstructions on CT
scans irrespective of the location and length of the lesions. CONCLUSION:
Good results can be expected from placement of Gianturco stents except when
CT shows the obstruction to be totally enveloped by tumor.
