Long-term Patency of Venous Stent After Sharp Recanalization for Benign Superior Vena Cava Occlusion

BACKGROUND/AIM: The incidence of benign superior vena cava syndrome (SVCS) is increasing due to the widespread use of central venous catheters and cardiac devices. Endovascular therapy is a first-line treatment option; however, recanalization of a completely occluded SVC remains technically challenging, and long-term stent patency data are limited. We report a case of central venous catheter-related benign SVCS treated with stent placement using a sharp recanalization technique and present the resulting 10-year patency outcome. CASE REPORT: A male patient in his 50s presented with facial and upper extremity edema secondary to benign SVCS caused by repeated central venous catheter placement for short-bowel syndrome. Venography revealed complete SVC occlusion (modified Stanford type 4). Sharp recanalization using a trans-septal needle was performed under biplane fluoroscopy and cone-beam computed tomography guidance, followed by placement of a self-expanding bare-metal stent (14 × 40 mm). Symptoms resolved the following day. In-stent re-stenosis occurred at 10 months and was successfully managed with balloon dilatation, after which the stent remained patent with no recurrence of SVCS on annual follow-up. Long-term patency of the stent was achieved for the next 10 years. CONCLUSION: Sharp recanalization using a trans-septal needle enabled safe and effective stent placement for completely occluded benign SVC. Long-term stent patency of 10 years was achieved with a single re-intervention, demonstrating that this technique is a viable treatment option for benign SVCS.