Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis
Background: 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 met...
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doaj-1ed27ee5c0eb417194078b2247662b9e2021-07-29T04:23:33ZengElsevierEClinicalMedicine2589-53702021-07-0137100970Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysisAbdul Hussain Azizi0Irfan Shafi1Matthew Zhao2Saurav Chatterjee3Stephanie Clare Roth4Maninder Singh5Vladimir Lakhter6Riyaz Bashir7Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United StatesDepartment of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, United StatesDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United StatesDivision of Cardiology, Department of Medicine, Northshore-LIJ Hospitals of Northwell Health, and Assistant Professor of Medicine, Zucker School of Medicine, New York, NY, United StatesGinsburg Health Sciences Library, Temple University, Philadelphia, PA, United StatesDivision of Cardiovascular Disease, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United StatesDivision of Cardiovascular Disease, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United StatesDivision of Cardiovascular Disease, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States; Corresponding author.Background: 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 technical success, restenosis, and recurrence 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 April 14, 2021 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 6,012 reports, of which 39 studies met our inclusion criteria and were included for analysis. A total of 2200 patients received ET for SVC syndrome. The weighted technical success rate was 98.8% (95% CI 98.2–99.3) with low heterogeneity (I2=17.4%, p = 0.185), restenosis rate was 10.5% (95% CI 8.4–12.6) with moderate heterogeneity (I2=53.5%, p<0.001), and recurrence rate was 10.8% (95% CI 8.1–13.5) with high heterogeneity (I2=75.8%, p<0.001). Total complication rate was 8.6% (95% CI 7.3%-9.9%) with a mean complication rate of 7.5% (95% CI 4.7%-10.3%). 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.http://www.sciencedirect.com/science/article/pii/S2589537021002509Superior vena cava syndromeEndovascular therapyCatheter-directed thrombolysisAngioplastyStents |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abdul Hussain Azizi Irfan Shafi Matthew Zhao Saurav Chatterjee Stephanie Clare Roth Maninder Singh Vladimir Lakhter Riyaz Bashir |
spellingShingle |
Abdul Hussain Azizi Irfan Shafi Matthew Zhao Saurav Chatterjee Stephanie Clare Roth Maninder Singh Vladimir Lakhter Riyaz Bashir Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis EClinicalMedicine Superior vena cava syndrome Endovascular therapy Catheter-directed thrombolysis Angioplasty Stents |
author_facet |
Abdul Hussain Azizi Irfan Shafi Matthew Zhao Saurav Chatterjee Stephanie Clare Roth Maninder Singh Vladimir Lakhter Riyaz Bashir |
author_sort |
Abdul Hussain Azizi |
title |
Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis |
title_short |
Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis |
title_full |
Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis |
title_fullStr |
Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis |
title_full_unstemmed |
Endovascular therapy for superior vena cava syndrome: A systematic review and meta-analysis |
title_sort |
endovascular therapy for superior vena cava syndrome: a systematic review and meta-analysis |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2021-07-01 |
description |
Background: 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 technical success, restenosis, and recurrence 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 April 14, 2021 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 6,012 reports, of which 39 studies met our inclusion criteria and were included for analysis. A total of 2200 patients received ET for SVC syndrome. The weighted technical success rate was 98.8% (95% CI 98.2–99.3) with low heterogeneity (I2=17.4%, p = 0.185), restenosis rate was 10.5% (95% CI 8.4–12.6) with moderate heterogeneity (I2=53.5%, p<0.001), and recurrence rate was 10.8% (95% CI 8.1–13.5) with high heterogeneity (I2=75.8%, p<0.001). Total complication rate was 8.6% (95% CI 7.3%-9.9%) with a mean complication rate of 7.5% (95% CI 4.7%-10.3%). 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. |
topic |
Superior vena cava syndrome Endovascular therapy Catheter-directed thrombolysis Angioplasty Stents |
url |
http://www.sciencedirect.com/science/article/pii/S2589537021002509 |
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