In this succinct article, the authors underscore the importance of having accurate tissue diagnosis prior to treating obstructing lesions. 1/3 of the patients had tumors best treated with chemotherapy (not radiation), and mediastinoscopy provides an effective way to obtain tissue for diagnosis.
Lochridge, SK; Knibbe, WP; and Doty, DB. Obstruction of the superior vena cava. Surgery 1979;85:14-24.
This early 10-year series of 66 patients covers a variety of therapeutic approaches, including venography. There is a thorough discussion at the end of the article to assist the reader in tailoring the approach to SVC obstruction.
Jackson, JE and Brooks, DM. Stenting of superior vena caval obstruction [review]. Thorax 1995;50 Suppl 1:S31-6.
18 out of 20 patients had a percutaneous intraluminal stent place to relieve obstruction. The article also reviews the use of thrombolysis and anticoagulation in SVC syndrome.
Abner, A. Approach to the patient who presents with superior vena cava obstruction [review]. Chest 1993;103 (4 Suppl):394S-397S.
A brief review article with good references. Topics include pathophysiology, radiologic studies, biopsy procedures, and eventual management of these patients.
Sources for further reading
Textbook Chapters
Chapter 37: The Mediastinum. Glenn's Thoracic and Cardiovascular Surgery (Baue, Geha, Hammond, Laks, and Naunheim), 6th ed., 658-9.
Recent on-line full-text journal articles