Venous compression syndromeI87.1

Venous compression syndromes are the clinical expression of a venous congestion caused by pressure or constriction from the outside, e.g. in the drainage area of the upper or lower vena cava (V. cava-superior syndrome (VCSS) or V. cava- inferior syndrome (VCIS)). Possibly also in the area of peripheral veins, e.g. in the popliteal fossa by a Baker cyst, on the arms by a lipoma.

This is caused by vein compressing processes from outside such as haematomas, cysts, fibroses, but also tumours. The most frequent cause of VCSS are space-consuming processes in the mediastinum - e.g. bronchial carcinomas, tuberculosis, sarcoidosis, lymphomas, mediastinal metastases. Most frequent cause of VCIS pregnancy or space-occupying processes in the abdomen.

Basically at any age, women and men equally. VCIS mainly in pregnant women.

Superior vena cava syndrome(VCSS): typical symptoms are dyspnea, cough, inspiratory stridor, swelling of the soft tissues of the neck and face, especially periobital, and possibly also of the arms. Less frequently, cyanosis, clouding of consciousness and/or headache (due to cerebral edema), exophthalmos, glottic or laryngeal edema.

Vena cava inferior syndrome(VCIS): Circulatory disturbances in the supine position (especially in pregnant women), possible unconsciousness or cardiac arrest if no countermeasures are taken. CAVE: Oxygen deficiency of the unborn child. In case of tumorous processes in the abdomen/pelvis, possibly also nephrotic syndrome due to concomitant compression of the renal vessels or chronic liver congestion, ascites, venous markings on the trunk if the hepatic veins are involved.

Clinical venous congestion signs, sonographic evidence of the congested vessels, if necessary also evidence of the space-occupying compressive structure, e.g. Baker's cyst. In case of central processes, further imaging diagnostics such as X-ray thorax, MRT and/or CT to detect the space-occupying structure.

Especially through compression of accompanying structures such as trachea, renal or liver vessels.

Depending on cause and localization. Therapy of the underlying disease, removal of the obstruction of the outflow, if necessary endovenous stents or bypasses, if necessary also anticoagulation and compression therapy. In pregnant women with VCIS, immediate repositioning in an upright or left-sided position is usually sufficient.