Large-bore catheter selection in endovascular management of superior vena cava syndrome

Acute superior vena cava syndrome (SVCS) is a clinical condition caused by obstruction of blood flow through the SVC, leading to facial swelling, dyspnea, and upper extremity edema. To date, no established guidelines exist regarding optimal device selection for thrombectomy in acute SVCS, and endovascular management with mechanical thrombectomy remains underreported in the literature. We discuss two similarly presenting cases of acute SVCS managed with different large-bore thrombectomy platforms—AngioDynamics AlphaVac and Inari FlowTriever—to highlight the need for case-specific device selection and to compare clinical outcomes.