Superior Vena Cava (SVC) Stent in Cyprus
Superior Vena Cava (SVC) stent insertion is a procedure in which Dr Zertalis uses ultrasound (US) and X-Rays (fluoroscopy) to insert a flexible metal mesh tube (stent) in a large vein known as the superior vena cava (SVC) to relieve obstruction and provide symptomatic following narrowing or blockage.
The superior vena cava (SVC) is a large vein that carries blood from the head, neck and arms back to the heart. If there is a narrowing or blockage of the SVC this can result in:
- swelling of the face and arms
- shortness of the breath
Stenting aims at relieving the narrowing or blockage, allow normal drainage of blood from the head, neck and arms back to the heart thus providing immediate symptomatic relief.
Superior Vena Cava (SVC) stenting is a safe, effective and accurate procedure, but as with any medical procedure there are some risks and complications that you may uncommonly experience.
Bleeding: Significant bleeding requiring treatment is rare. Uncommonly, a blood transfusion may be required and rarely an interventional radiological or surgical procedure may be necessary to stop ongoing bleeding.
Infection: SVC Stenting requires direct access to the bloodstream hence there is a very small risk of infection.
Allergy to contrast (X-ray dye): Adverse events are uncommon, mild and can be managed safely in our department. A major life-threatening contrast reaction is rare (< 0.005%).
Kidney Impairment: Impairment of kidney function can occur due to the contrast (X-ray dye) or dehydration. You will have a drip placed before the procedure to ensure adequate hydration and to minimise the risk of problems with kidney function.
Radiation Risk: Immediate harmful effects such as skin burns, or radiation sickness are extremely rare. The radiation dose you receive during the procedure is monitored to prevent this. On rare occasions the procedure will have to be stopped if the threshold for immediate harmful effects is reached. Increase in lifetime risk of cancer due to radiation per examination is also rare (< 0.001%).
Failure: Very rarely, Dr Zertalis will be unable to place the stent satisfactorily in the SVC. If this happens, you may require a repeat procedure. The stent can move out of position or become blocked. Insertion of a new stent may become necessary although this is rare.
Dr Zertalis will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
Before the procedure
The procedure is performed under local anaesthetic and with sedation if necessary. You will be asked not to eat or drink for 6 hours before the procedure. Where necessary a blood test may be required. A short and thin plastic tube (cannula) will be placed into a vein in your arm.
Please let Dr Zertalis know about any medications you take, any allergies you may have and if you previously have had a reaction to the x-ray dye (contrast).
You will be asked to change into a hospital gown and lie on your back. You will have devices attached to your chest, arm and finger to monitor you pulse, blood pressure and oxygen levels. You will be given a sedative to relieve anxiety and painkillers where necessary. This is standard for all minimally invasive interventional radiology procedures performed in Cyprus.
The procedure is performed under sterile conditions and Dr Zertalis will wear sterile gowns and gloves to carry out the procedure. The skin near the point of insertion will be swabbed with antiseptic and you will be covered with sterile drapes.
Your skin near the point of insertion will be numbed using local anaesthetic. When the local anaesthetic is injected you will likely experience a burning sensation for 30 to 60 seconds.
Following an injection with local anaesthetic, a small cut (incision) is made in the skin and Dr Zertalis will use ultrasound (US) and X-Rays (Fluoroscopy) to navigate a fine needle into a vein either in the neck or the groin to access the bloodstream.
Small volume of x-ray dye (contrast) will be used to define the anatomy of your Superior Vena Cava (SVC) and associated blood vessels. You may experience a warm feeling in your chest during the injection – this is normal. The stent is placed in the SVC across the narrowing or blockage and pressure is applied to the skin at the site of entry to prevent bleeding.
Every patient is different, however, expect to be in the radiology department for up to 1 hour.
After the procedure
You will be transferred to your ward where your pulse, blood pressure, oxygen levels and the entry site in the skin will be checked by our team at regular intervals. You should expect to be in bed for up to 6 hours. Most patients are well enough to go home on the same day but occasionally some patients will need to stay in hospital overnight.