Two weeks after initially successful stenting for malignant superior vena cava obstruction, a patient again develops facial swelling and venous

Question

Two weeks after initially successful stenting for malignant superior vena cava obstruction, a patient again develops facial swelling and venous distension. Imaging shows loss of flow through the stent. Which mechanism most plausibly explains recurrence?

Accepted Answer

In-stent thrombosis or tumour ingrowth causing recurrent luminal obstruction

Answer

Dexamethasone withdrawal causing mechanical collapse of an otherwise patent stent

Answer

Resolution of the original tumour converting normal venous flow into obstruction

Answer

A delayed immunoglobulin-E reaction selectively narrowing the vena cava lumen

Answer

Progressive dissolution of the metallic stent into the systemic circulation

SVC Stent Re-Occlusion — SCE Palliative Medicine MCQ

Two weeks after initially successful stenting for malignant superior vena cava obstruction, a patient again develops facial swelling and venous distension. Imaging shows loss of flow through the stent. Which mechanism most plausibly explains recurrence?