Endovascular Therapy for SVC Syndrome – A Systematic Review

Objective: Superior vena cava (SVC) syndrome is caused by the obstruction of the SVC and can result in significant morbidity and mortality. In contemporary practice, endovascular therapy (ET) has become the standard of care for a majority of these patients. This study is a systematic review and meta-analysis of the available literature to assess the contemporary outcomes of SVC syndrome following endovascular intervention. Methods: For this meta-analysis, we conducted a systematic literature review of PubMed, Cochrane Library, and Embase databases from inception to September 25, 2020 for studies on ET for SVC syndrome. Studies included full-length journal articles on the use of ET among adults with SVC syndrome. Case reports or case series with fewer than 20 patients were excluded. We evaluated the endpoints of technical success rate, restenosis rate, and recurrence rates in SVC syndrome patients after endovascular stenting. The results of this study were calculated using random-effects models. Findings: We identified 5730 reports, of which 38 studies met our inclusion criteria and were included for analysis. A total of 2158 patients received ET for SVC syndrome. The weighted technical success rate was 98.9% (95% CI 98.3-99.4), restenosis rate was 10.6% (95% CI 8.5–12.8), and recurrence rate was 10.3% (95% CI 7.6–12.9). Complication rates were 7.35 ± 0.0786%. Interpretation Our systematic review revealed high technical success, low restenosis, and low recurrence rates following ET. Collectively, these results support the paradigm of ET as an effective and safe treatment for patients with SVC syndrome. Funding: None Declaration of Interest: Dr. Riyaz Bashir has an equity interest in Thrombolex Inc. All other authors have no competing interests to disclose.