Gianturco Z-Stent Fixation of a Modified Iliac Limb Stent-Graft Endoprosthesis for the Treatment of Malignant Superior Vena Cava Syndrome

Superior vena cava (SVC) syndrome, characterized by facial and arm swelling, is most frequently caused by intrathoracic malignancies. Decompression may be achieved with endovenous stent placement. Polytetrafluoroethylene-covered stents have shown to have higher long-term cumulative patency rates compared with uncovered stents for the treatment of malignant SVC syndrome. Unfortunately, polytetrafluoroethylene-covered stents are not readily available worldwide. Moreover, the existing armamentarium, including balloon-expandable iCAST stents (maximum diameter 10 mm) and heparin-coated Viabahn stent-graft endoprostheses (maximum diameter 13 mm), is too small to adequately treat malignant obstruction of the SVC. This report describes a patient with SVC syndrome and SVC tumor thrombus secondary to recurrent nonseminomatous germ cell carcinoma of the mediastinum treated with a Gianturco Z-stent-fixed modified EXCLUDER abdominal aortic aneurysm iliac limb endoprosthesis.