Journal of Vascular and Interventional Radiology
Volume 21, Issue 1 , Pages 140-143 , January 2010

Embolization of a Symptomatic Systemic to Pulmonary (Right-to-left) Venous Shunt Caused by Fibrosing Mediastinitis and Superior Vena Caval Occlusion

  • Daniel Y. Sze, MD, PhD

      Affiliations

    • Division of Interventional Radiology, H-3646, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5642
    • Corresponding Author InformationAddress correspondence to D.Y.S.
    • ,
  • Dominik Fleischmann, MD

      Affiliations

    • Division of Cardiovascular Imaging, H-3646, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5642
    • ,
  • Adrian O. Ma, MD

      Affiliations

    • Division of Cardiovascular Medicine, H-3646, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5642
    • ,
  • Elizabeth A. Price, MD

      Affiliations

    • Division of Hematogy, H-3646, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5642
    • ,
  • Michael V. McConnell, MD, MSEE

      Affiliations

    • Division of Cardiovascular Medicine, H-3646, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5642

Received 16 April 2009 ,Revised 12 September 2009 ,Accepted 27 September 2009.

References 

  1. Wilson ES. Systemic to pulmonary venous communication in the superior vena caval syndrome. AJR Am J Roentgenol. 1976;127:247–249
  2. Muramatsu T, Mashimo M, Miyamae T, Dohi Y. Rare collateral pathway in superior vena cava obstruction: the development of the venous shunts between systemic veins and the left heart. Clin Nucl Med. 1987;12:241–242
  3. Taki J, Bunko H, Tonami N, Hisada K. Shunt between right subclavian vein and the left heart in superior vena cava obstruction due to lung cancer. Clin Nucl Med. 1990;15:251–253
  4. Kume N, Suga K, Uchisako H, Matsui M, Shimizu K, Matsunaga N. Abnormal extrapulmonary accumulation of 99mTc-MAA during lung perfusion scanning. Ann Nucl Med. 1995;9:179–184
  5. Grayet D, Ghaye B, Szapiro D, Dondelinger RF. Systemic-to-pulmonary venous shunt in superior vena cava obstruction revealed on dynamic helical CT. AJR Am J Roentgenol. 2001;176:211–213
  6. Kim HC, Chung JW, Park SH, et al. Systemic-to-pulmonary venous shunt in superior vena cava obstruction: depiction on computed tomography venography. Acta Radiol. 2004;45:269–274
  7. Ito H, Nakayama S, Aso N, et al. Systemic to pulmonary venous shunt in lung cancer with obstruction of superior vena cava: case report with review of the literature. Radiation Med. 2005;236:447–450
  8. Ho HT, Horowitz AL, Ho AC. Systemic to pulmonary venous communication (right-to-left shunt) in superior vena cava obstruction demonstrated by spiral CT. Brit J Radiol. 1999;72:712–713
  9. Nguyen BD, Roarke MC. Superior vena cava obstruction with intrahepatic and systemic-pulmonary venous right-to-left shunts. Clin Nucl Med. 2004;29:491–493
  10. Schepers-Bok R, Mallens WM. Obstruction of the superior vena cava due to aortic dissection: CT findings of collateral venous flow via the bronchial veins. Eur Radiol. 1996;6:753–755
  11. Gale B, Chen C, Chun KJ, Lan J, Cynamon J, Freeman LM. Systemic to pulmonary venous shunting in superior vena cava obstruction: unusual myocardial and thyroid visualization. Clin Nucl Med. 1990;15:246–250
  12. Kistler AM, Silverman ED, Sharpe MB, Yudt WM, Camponovo EJ. Superior vena cava obstruction in fibrosing mediastinitis: demonstration of right-to-left shunt and venous collaterals. Nucl Med Comm. 1991;12:1067–1074
  13. Stockberger SM, West KW, Cohen MD. Right-to-left shunt from systemic venous to pulmonary venous system developing after SVC obstruction. J Comput Assist Tomogr. 1995;19:312–315
  14. Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR. Fibrosing mediastinitis. Radiographics. 2001;21:737–757
  15. Meacham RR, Headley AS, Bronze MS, Lewis JB, Rester MM. Impending paradoxical embolism. Arch Intern Med. 1998;158:438–448
  16. Troost E, Gewillig M, Budts W. Percutaneous closure of a persistent left superior vena cava connected to the left atrium. Int J Cardiol. 2006;106:365–366

 D.Y.S. is a consultant for MediGene, Inc., Jennerex Biotherapeutics, Inc., and Pain Therapeutics, Inc., and is a shareholder of NDC, Inc., none of which are pertinent to this manuscript. None of the other authors have identified a conflict of interest.

PII: S1051-0443(09)00964-6

doi: 10.1016/j.jvir.2009.09.022

Journal of Vascular and Interventional Radiology
Volume 21, Issue 1 , Pages 140-143 , January 2010

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