Rezaee A, Shah V, Tatco V, et al. Superior vena cava obstruction (grading). Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-43853
SVC obstruction can cause SVC syndrome which is the most common condition affecting this vessel. It can be secondary to extrinsic compression or intraluminal thrombosis/stenosis. Collateral pathways, with the azygos vein being the most important collateral vessel, form in response to severe narrowing or obstruction to drain blood into the heart.
Five distinct grades of SVC obstruction have been described:
grade 0: SVC narrowing without clinical evidence of SVC syndrome
grade I:
Ia: mild SVC narrowing without collaterals
Ib: Moderate SVC narrowing without collaterals
grade II: severe SVC narrowing above the azygos with the azygos vein serving as partial collateral