{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T12:30:35Z","timestamp":1761741035805,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background\/Objectives: A knowledge gap persists regarding anticoagulation therapy after endovascular stent insertion for malignant superior vena cava obstruction (mSVCO). Guidelines are supported by retrospective studies with a radiological focus and lack specific drug recommendations. No studies to date have captured the multi-disciplinary nature of decision-making over time. Methods: This single-center retrospective service evaluation includes patients with solid organ malignancy who received a stent for mSVCO between July 2016 and May 2022. Patient and treatment characteristics, clinical outcomes and prescribing decisions were collected from medical records and analyzed. Results: Of 49 patients (55% female, mean age 59), 73% had metastatic extra-thoracic disease at stent insertion. Technical success was achieved in 98% of cases and 92% survived to discharge. Forty-eight patients were followed until death. Median survival was 2.4 months. Post-procedure imaging (performed in 55% of patients) revealed 10 (21%) cases of systemic venous thromboembolism and 7 cases of stent thrombosis. Forty-four (91%) patients received anticoagulation therapy (62% therapeutic dose low molecular weight heparin). Those with thrombotic complications were fitter pre-procedurally than the rest of the cohort. There was one case of major bleeding. Twenty-two instances of therapy modification occurred following the initial plan, including nine changes due to a patient preference for oral therapy. Conclusion: Patients undergoing stenting for mSVCO demonstrate high thrombotic risk and a poor prognosis. Anticoagulation plans are frequently modified post discharge due to changing risk profiles and patient preferences. Multi-disciplinary collaboration is essential to support patient-centered and individualized management. Future research should investigate direct oral anticoagulants and anti-platelet therapy and develop risk assessment tools for this population.<\/jats:p>","DOI":"10.3390\/curroncol32110601","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T05:48:46Z","timestamp":1761716926000},"page":"601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Analysis of Endovascular Stent Insertion for Malignant Superior Vena Cava Obstruction, Focusing on Anticoagulation Practices"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6685-4906","authenticated-orcid":false,"given":"Joshua","family":"Walker","sequence":"first","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Trust, Guy\u2019s Hospital, Great Maze Pond, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amsajini","family":"Ravinthiranathan","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Trust, Guy\u2019s Hospital, Great Maze Pond, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9970-0522","authenticated-orcid":false,"given":"Athanasios","family":"Diamantopoulos","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Trust, Guy\u2019s Hospital, Great Maze Pond, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5635-7696","authenticated-orcid":false,"given":"Spyridon","family":"Gennatas","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Trust, Guy\u2019s Hospital, Great Maze Pond, London SE1 9RT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7500-9251","authenticated-orcid":false,"given":"Alexandros","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Trust, Guy\u2019s Hospital, Great Maze Pond, London SE1 9RT, UK"},{"name":"School of Cancer & Pharmaceutical Sciences, King\u2019s College London, Guy\u2019s Campus, Great Maze Pond, London SE1 1UL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1053\/clon.2002.0095","article-title":"Steroids, Radiotherapy, Chemotherapy and Stents for Superior Vena Caval Obstruction in Carcinoma of the Bronchus: A Systematic Review","volume":"14","author":"Rowell","year":"2002","journal-title":"Clin. 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