Catheter-directed thrombolysis for acute SVC obstruction in a patient with metastatic breast cancer

Abstract

We report a case of acute port-a-cath associated superior vena caval thrombosis in a longstanding, previously uncomplicated vascular access device in a patient with stable ER+/PR+/HER2+ metastatic breast cancer. There was limited clinical improvement following initial treatment with subcutaneous low molecular weight heparin (LMWH). Following multidisciplinary team discussion, it was decided to proceed with catheter-directed thrombolysis, which resulted in complete symptom resolution.

Keywords

• SVC obstruction
• metastatic breast cancer
• thrombolysis
• port-a-cath
• venous access device
• anticoagulation