A Superior Treatment for Superior Vena Cava Syndrome

In their case report of a woman withsuperior vena cava syndrome (CONSULTANT,September 15, 2002, page1391), Drs Sonia Arunabh and K.Rauhilla appropriately indicate thatradiation therapy is the primary treatmentwhen the syndrome is caused bysolid malignancies.However, radiationmay not achieve decompression rapidlyenough to save the patient's life. Emergentextracorporeal venous shuntingcan relieve the acute life-threateningcondition and allow time for more definitivetherapy.
-- Alan W. Feld, MD
   Las Vegas
I am familiar with the techniqueyou describe; however, it is seldomused nowadays. Because of advancementsin diagnostic modalities,superior vena cava syndromeis now diagnosed in most patientsat a much earlier stage, which obviatesthe need for this procedure.-- Sonia Arunabh, MD
   New Hyde Park, NY