Persistent left superior vena cava: A possible contraindication to chemotherapy and total parenteral nutrition in cancer patients

Francesco Iovino, Pasquale Pio Auriemma, Luca Del Viscovo, Sara Scagliarini, Marilena Di Napoli, Ferdinando De Vita

Research output: Contribution to journalArticlepeer-review

Abstract

Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. Awareness of this condition may be useful when placement of left-side transvenous subclavian or internal jugular catheters is required. This anomaly may be detected only by chest radiograph following placement of the catheter. The primary endpoints of this study were to analyze the prevalence of PLSVC, measurement of its diameters and the outcome of cancer patients with this anomaly undergoing placement of a long term catheter for nutrition and chemotherapy at the Department of Surgery, of the Second University of Naples, Naples, Italy. A total of 600 consecutive adult patients with hematological or solid tumors admitted to our surgery department for implantation of a central venous catheter (CVC) were considered. The CVC was routinely implanted in the left internal jugular vein under ultrasound guidance. Four cases of PLSVC (0.6% of patients) were observed and confirmed using cine magnetic resonance imaging (MRI). In all cases, the CVC was not removed. Three patients underwent chemotherapy and one patient was subjected to total parenteral nutrition. In the three patients undergoing chemotherapy, dynamic ECG and echocardiography were performed at the end of the treatment. No disturbances of the cardiac rhythm or thrombosis were detected, and heart ejection fraction (EF) was not affected. In conclusion, although PLSVC may be a risky condition, no complications occurred in our study. Thus, PLSVC should not be regarded as a strict contraindication to infusion of chemotherapy or hyperosmolar nutritional solutions. However, further research is needed to confirm our data.

Original languageEnglish
Pages (from-to)759-762
Number of pages4
JournalOncology Letters
Volume4
Issue number4
DOIs
Publication statusPublished - Oct 2012

Keywords

  • Cancer patients
  • Central venous catheter
  • Persistent left superior vena cava

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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