Fig. 3.

A 52-year-old woman with a history of metastatic breast cancer and indwelling port developed facial swelling and airway edema. Chest CT demonstrated complete thrombotic occlusion of the SVC around the port-a-catheter and mediastinal and chest wall collaterals including a large azygous vein (arrow, a ). The etiology of her SVC syndrome was considered mixed due to a combination of compressive mediastinal adenopathy, indwelling foreign body, and malignancy-associated hypercoagulable state. Placement of a 20-mm-diameter Cook-Z stent (Cook Medical) followed by 14-mm post-deployment balloon dilation led to prompt relief of facial swelling and airway edema. Follow-up CT 3 months later demonstrated a patent SVC stent (arrow) but progression of disease ( b ).