Endovascular Stenting for Malignant Obstruction of Superior Vena Cava Lingegowda et al. THIEME 136 Endovascular Stenting for Malignant Obstruction of Superior Vena Cava: A Single-Center Experience Using the Body Floss Technique Dayananda Lingegowda 1 Bharat Gupta 1 Anisha Gehani 1 Priya Ghosh 1 Sumit Mukhopadhyay 1 1 Department of Radiology, Tata Medical Center, Newtown, Kolkata, West Bengal, India published online April 14, 2021 Address for correspondence Dayananda Lingegowda, MBBS, DNB, Department of Radiology, Tata Medical Center, 14 Arterial Road, Newtown, Kolkata 700160, West Bengal, India (e-mail: dayanandal@gmail.com). Purpose Endovascular stenting is the treatment of choice for malignant obstruc- tion of the superior vena cava (SVC) when rapid symptomatic relief is desired. Body floss technique is not routinely used during SVC stenting but has few advantages over single-access technique. We report our experience with stenting for malignant obstruction of the SVC using the body floss technique. Materials and Methods Between March 2015 and March 2020, 25 patients (20 men, 5 women; median age, 65 years) with malignant SVC obstruction underwent endovas- cular stenting of the SVC. We retrospectively evaluated these patients for clinical and technical success rates, complications, recurrence-free survival, and overall survival. Results Stent placement was successful in 24/25 patients (technical success: 96%). Clinical success was achieved in 23/25 (92%) patients. A mortality rate of 4% (1/25) was noted due to SVC rupture. Partial stent migration was noted in two patients (8%) and was treated by placing an additional overlapping stent. Incidental early stent thrombosis was seen in two patients within 8 hours of stent placement, but these patients showed symptom relief with anticoagulation. Follow-up imaging confirmed stent patency in all patients. Late stent occlusion due to tumor progression was seen in one patient. The primary patency rate was 88% (22/25). Overall median survival of 133 days was observed (range: 1–847 days). Conclusion Endovascular stenting of the SVC for malignant obstruction using the body floss technique is associated with high technical and clinical success, and low rate of complications. Abstract DOI https://doi.org/ 10.1055/s-0041-1728975 ISSN 2457-0214 © 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Introduction Superior vena cava (SVC) syndrome is a clinical condi- tion resulting from venous hypertension secondary to SVC obstruction (SVCO). 1 Malignant etiology accounts for more than 90% of cases of SVCO, with bronchogenic carcinoma accounting for at least 50%. 2,3 SVCO is seen in up to 4% of all diagnosed bronchogenic cancers, and squamous cell carci- noma is the subtype most frequently associated with SVCO. 1,4 Traditionally, malignant SVC syndrome is treated with radiotherapy and chemotherapy. 4 Endovascular stenting of the SVC has gained popularity and has become the treatment J Clin Interv Radiol ISVIR 2021;5:136–141. Keywords ► superior vena cava obstruction syndrome ► SVC obstruction ► body floss technique Original Article Published online: 2021-04-14