Superior Vena Cava Syndrome Caused by Pulmonary Catheters

To the Editor.  —We read with interest the report of Gore et al¹ describing three patients with superior vena cava syndrome caused by pulmonary artery catheters. The authors suggest, based on a good response in two of the patients, that catheter removal and heparin sodium therapy be the treatment of choice in this group. They mentioned briefly, that thrombolytic therapy might be considered in selected patients.We wish to call the authors' attention to previously published cases in the Archives^2,3 in which streptokinase was used with prompt success, without complications, in similar circumstances. In our case, in which permanent pacemaker wires were the cause, streptokinase resulted in prompt clot resolution without removal of either pacer wire. While it is clear that the authors' patients were more seriously ill than those previously cited, we wonder if thrombolytic therapy might have altered the outcome in the patient who did not