A 45 year, male patient with history of sarcoidosis >18 years, presents with asymptomatic right moderate pleural effusion. His clinical findings suggest SVC obstruction. His X-ray chest reveals right pleural effusion. On draining 750 ml pleural fluid - labs suggest transudate. His blood chemistry is unremarkable.
His CT chest reveals severe SVC obstruction and complete obstruction of right pulmonary artery & veins, along with mild right lung involvement and moderate pleural effusions. There are multiple collaterals developed. His ECG and Echo studies are normal with no evidence of pulmonary hypertension. What should be the future course of management for him?
