ArticleBMC surgery2026
Acute superior vena cava collapse after thymic carcinoma resection and failed pericardial bypass rescued by endovascular stenting: a case report.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThymic carcinoma with superior vena cava (SVC) invasion is challenging. Intraoperative acute SVC syndrome may result from extrinsic compression after venous reconstruction. Intraoperative acute superior vena cava collapse due to extrinsic compression following thymic carcinoma resection and venous reconstruction appears to be infrequently reported and offers important insights into graft selection and rescue strategies. CASE PRESENTATION: A 77-year-old woman with stage III thymic squamous cell carcinoma achieved partial response after cisplatin/nab-paclitaxel with camrelizumab. Resection included stapled SVC venoplasty; during chest closure, central venous pressure (CVP) surged to 40 mmHg. An autologous pericardial bypass between the right innominate vein and right atrium temporarily normalized CVP, yet a second CVP spike occurred after re-closure. Angiography revealed severe proximal SVC narrowing consistent with extrinsic compression. Immediate endovascular stenting with sequential balloon dilations restored patency and stability.
conclusionsWhen autologous pericardial bypass collapses under extrinsic compression, immediate endovascular stenting provides a rational, time-critical rescue to re-establish SVC flow. Recognizing mechanical causes of collapse and anticipating external pressure can guide graft selection and intraoperative decision-making.
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