May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

scholarly journals Iatrogenic Venous Compression Syndrome due to Surgical Lumbar Hardware

2021 ◽  
Vol 5 (3) ◽  
pp. 140-145
Author(s):  
Muhammad Akram Khan ◽  
◽  
Zahoor Khan ◽  
Abeera Azam ◽  
◽  
...  
Keyword(s):  
Iliac Vein ◽  
Pelvic Surgery ◽  
Venous Disease ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Left Lower Extremity ◽  
Venous Compression ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome

Abstract: Background: The Iliac vein compression syndrome (IVCS) is most commonly due to May-Thurner variant, an anatomic variant where in the right common iliac artery overlies the left common iliac vein and compresses it against the lumbar spine. The compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, or deep vein thrombosis in the iliofemoral veins. The role of the pelvic surgery particularly the lumbar hardware in the development of symptomatic Venous compression syndrome in patients with May-Thurner syndrome is not well understood. The incidence is presumably very low. Herein, we present six patients who developed IVCS after Lumbar hardware. Method: The cases were diagnosed between Nov. 2016 to Oct. 2019 in the Outpatient Cath Lab of McKinney, TX. The patient’s medical records were retrospectively analyzed looking for risk factors, clinical features, venogram findings, and post venogram. The evaluation of each case was described, and common trends were later presented in a cross-case analysis. Conclusion: The cases presented in this report suggest that the hardware used in lumbar/spinal surgery could lead to an IVCS. Patient’s symptoms are unspecific. Venogram/venoplasty is the gold standard for diagnosis and treatment. It is imperative having a high level of suspicion and familiarizing with the natural history of IVCS due to the invasive nature of venogram and the relevance of an early diagnosis to reduce the occurrences of complications. Keywords: Venous disease, Iliac vein compression, May-Thurner syndrome, Lumbar surgery complications, Unexplained edema of left leg, May-Thurner Syndrome, Lumbar hardware, Venous compression, IVUS, Venogram, Angioplasty

scholarly journals Iliac vein compression syndrome: literature review

2015 ◽  
Vol 14 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Leonardo Pessoa Cavalcante ◽  
José Emerson dos Santos Souza ◽  
Raquel Magalhães Pereira ◽  
Marcos Velludo Bernardes ◽  
Alan Maurice da Silva Amanajás ◽  
...  
Keyword(s):  
Color Doppler ◽  
Iliac Vein ◽  
Surgical Reconstruction ◽  
Diagnostic Tools ◽  
Screening Methods ◽  
Common Iliac Vein ◽  
Noninvasive Methods ◽  
Compression Syndrome ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome

Iliac vein compression syndrome is a clinical condition in which the right common iliac artery extrinsically compresses the left common iliac vein. The syndrome predominantly affects young women between their 2nd and 4th decades of life. In view of the syndrome's potential complications, it should be recognized/diagnosed and treated in symptomatic patients before it causes irreversible damage to patients' venous systems. Noninvasive methods, such as venous color Doppler US are reasonable screening methods, but angiotomography and magnetic resonance angiography are more reliable diagnostic tools and the method of choice for confirmation of diagnosis remains multi-plane phlebography with measurement of pressure gradients. Endovascular treatment (angioplasty with placement of self-expanding stents) is safe and effective and can replace open surgical reconstruction and/or anticoagulation alone.

scholarly journals Thrombectomy Combined with Intravascular Angioplasty for the Treat- ment of Iliac Vein Compression Syndrome and Deep Vein Thrombosis

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Yang Baocai
Keyword(s):  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Control Group ◽  
Study Group ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
Deep Vein ◽  
Better Than

To investigate the effect of thrombectomy combined with in travascular injection (PTA) on the treatment of iliac vein compression syndrome (IVCS) and deep vein thrombosis (DVT). 50 patients with IVCS and DVT were enrolled in this study from January 2013 to December 2016. They were randomly divided into two groups. The control group was treated with thrombolytic therapy. The study group was treated with thrombus aspiration combined with PTA. The therapeutic effect of the study group was significantly better than that of the control group (P < 0.05).Thrombectomy combined with intravascular stenting for the treatment of iliac vein compression syndrome and deep vein thrombosis is better than the second stage.

scholarly journals Sonography’s Role in the Diagnosis of May–Thurner Syndrome

2017 ◽  
Vol 34 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Ashley Barry
Keyword(s):  
Lower Extremity ◽  
Iliac Vein ◽  
Postthrombotic Syndrome ◽  
Venous Disease ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Anatomic Variant ◽  
Left Lower Extremity ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome

May–Thurner syndrome (MTS), also known as Cockett syndrome or iliac vein compression syndrome, is a condition in which patients develop swelling, deep vein thrombosis (DVT), venous insufficiency, and other symptoms of the left lower extremity due to an anatomic variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. Although it is an uncommonly diagnosed condition, it is estimated to compose up to half of cases of left lower extremity venous disease. Although having some degree of iliac vein compression is considered a normal anatomic variant in an asymptomatic patient, those who experience severe swelling, venous reflux, and DVT often have anatomically abnormal veins with a spur formation. With proper technique and proficiency, transabdominal sonography can be used as a valuable diagnostic tool in the discovery and to facilitate treatment of May–Thurner syndrome. Diagnostic ultrasound also can monitor the development of recurring DVT and identify symptoms of postthrombotic syndrome.

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