Incidence and clinical significance of iliac vein compression

Vascular ◽  
2014 ◽  
Vol 23 (4) ◽  
pp. 337-343 ◽  
Author(s):  
M Nazzal ◽  
M El-Fedaly ◽  
V Kazan ◽  
W Qu ◽  
AW Renno ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Iliac Vein ◽  
Adjacent Segment ◽  
Common Iliac Vein ◽  
Chi Square ◽  
Vein Thrombosis ◽  
History Of ◽  
The Right ◽  
Deep Vein

Objectives To determine the frequency of left common iliac vein (CIV) compression by the right common iliac artery (CIA) based on CT scan images. Methods CT scan images were reviewed and the diameter of CIV was measured at the area of minimal diameter and compared to the distal adjacent segment and the contralateral CIV at the same level. Medical records were reviewed for symptoms, deep vein thrombosis (DVT) and risk factors that might be associated with DVT. Data were analyzed with SPSS program using both Chi square and t test. A p < 0.05 was considered statistically significant. Linear regression (R2) was used to evaluate correlation. Results A total of 300 complete records were reviewed. The mean age was 51.89 years, with 126 (42%) males. Comparison between the two groups (>70% vs <70%) showed similar clinical factors such as history of DVT, surgery, immobilization, malignancy, limb trauma, pregnancy, obesity, CHF, and smoking. There were more females with CIV compression of 70% or more than males (19.5% vs 11.1% P < .049). Conclusion Diameter stenosis more than 70% was present in 30.6% of cases with higher incidence in females. The presence of stenosis was not associated with the presence of clinical symptoms.

scholarly journals A case of May-Thurner Syndrome: An old anomaly but, a new suggestion: A case report

2019 ◽  
Vol 31 (3) ◽  
pp. 230-232
Author(s):  
Şule Gökçe
Keyword(s):  
Case Report ◽  
Sports Medicine ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Ultrasound Screening ◽  
Vascular Abnormalities ◽  
Vein Thrombosis ◽  
History Of ◽  
The Right ◽  
Deep Vein

May-Thurner syndrome (MTS) is an anatomical condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine. MTS is rarely diagnosed because diagnostic workup is seldom continued once the diagnosis of a deep vein thrombosis (DVT) has been established. Furthermore, patients with DVT generally have several well-known confounding risk factors. We report a 16-year-old girl with a history of left leg swelling who was incidentally diagnosed with MTS. We hope that our case report will create awareness of vascular abnormalities in sports medicine and suggest that routine venous Doppler ultrasound screening may help to detect MTS or associated anatomical prior to the formation of early thrombosis.

scholarly journals Nonnegligible causes of symptoms of acute lower extremities——3 cases of May-Thurner syndrome with deep vein thrombosis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Sun ◽  
Shenghan Song
Keyword(s):  
Computed Tomography ◽  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Catheter Directed Thrombolysis ◽  
The Right ◽  
Deep Vein

Background May-Thurner syndrome is a kind of disease caused by the compression of the left common iliac vein. It is one of the causes of incomplete venous valves and superficial varicose veins in lower limbs, and is also a potential factor of acute deep vein thrombosis (DVT). Method Here 3 cases are diagnosed as May-Thurner syndrome at different ages. Case presentations 1. A 35-year-old female patient was hospitalized with swelling of the left lower limb for 1 week. Computed tomography (CT) showed compression of the left common iliac vein with thrombosis. May-Thurner syndrome was diagnosed and catheter-directed thrombolysis was performed. 2. A 37-year-old male patient came to our hospital due to sudden swelling of the right lower extremity and pain for 3 days. Computed tomography showed compression of the left common iliac vein and deep venous thrombosis (DVT) of the right iliac vein. May-Thurner syndrome was diagnosed. The patient was performed with inferior vena cava (IVC) filter implantation, catheter-directed thrombolysis and balloon angioplasty for right iliac vein. And the patient recovered well; 3. A 55-year-old female patient came to our hospital with swelling and discomfort in the left lower extremity for 3 days. Computed tomography showed stenosis of the left common iliac vein with deep vein thrombosis. May-Thurner syndrome was diagnosed, balloon dilation and stent implantation were performed. During 3 years of follow-up, there was no swelling or new thrombosis in her lower limbs. Conclusion When encountering unexplained deep vein thrombosis, iliac vein compression syndrome should be considered and treated in time to prevent the recurrence of thrombosis. Catheter-directed thrombolysis can relieve symptoms and stenting placement is the optimal way to relieve stenosis, supplemented by long-term anticoagulation therapy and graduated compression stockings.

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 May-Thurner Syndrome Is Aggravated by Pregnancy

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 222
Author(s):  
Kuntharee Traisrisilp ◽  
Manatsawee Manopunya ◽  
Tanop Srisuwan ◽  
Wisit Chankhunaphas ◽  
Theera Tongsong
Keyword(s):  
Conservative Treatment ◽  
Renal Agenesis ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Left Lower Extremity ◽  
Asymptomatic Patients ◽  
Pregnancy And Postpartum ◽  
Anticoagulant Prophylaxis ◽  
The Right ◽  
Deep Vein

This study aims to emphasize that asymptomatic patients with undiagnosed and asymptomatic May-Thurner syndrome (MTS) may firstly develop severe compression during pregnancy. A 40-year-old woman, G1P0, at 22 weeks of twin gestation presented with left lower extremity edema and pain. One twin was structurally normal while the other had bilateral renal agenesis with oligohydramnios. Magnetic resonance venography (MRV) revealed severe compression of the left iliac vein by the right iliac artery without evidence of deep vein thrombosis (DVT). Conservative treatment with anticoagulant prophylaxis was instituted throughout the rest of pregnancy and postpartum period. She was also complicated with severe pre-eclampsia, a cesarean section was performed due to a prolapsed cord at 27 weeks of gestation, and she gave birth to a surviving baby weighing 1100 g. In conclusion, this case report provides evidence that pregnancy can disclose a subtle May-Thurner anatomy to be symptomatic without DVT. Successful pregnancy outcomes could be achieved with conservative treatment and anticoagulant prophylaxis.

scholarly journals Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

2013 ◽  
Vol 12 (2) ◽  
pp. 118-122
Author(s):  
Liz Andrea Villela Baroncini ◽  
Graciliano Jose Franca ◽  
Aguinaldo de Oliveira ◽  
Enrique AntonioVidal ◽  
Carlos Eduardo Del Valle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Below The Knee ◽  
Clinical Conditions ◽  
Deep Vein

BACKGROUND: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

scholarly journals Percutaneous thrombectomy using a novel single session device for acute iliofemoral deep vein thrombosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 74-77
Author(s):  
Gerard O’Sullivan
Keyword(s):  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Left Thigh ◽  
Common Iliac Vein ◽  
Single Session ◽  
Venous Thrombectomy ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Deep Vein ◽  
Percutaneous Thrombectomy

Summary: A 74-year-old woman presented with acute symptomatic left thigh and calf swelling; imaging demonstrated evidence of occlusive thrombosis from the upper left common iliac vein to the mid-thigh. Single session zero-thrombolysis venous thrombectomy was performed using the ReVeneTM Thrombectomy Catheter.

Modified Sling Technique for Difficult Filter Retrieval

2021 ◽  
Vol 39 ◽  
Author(s):  
Pasquale Grillo ◽  
◽  
Giuseppe Granata ◽  
Anna Savoldi ◽  
Giovanni Rodà ◽  
...  
Keyword(s):  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
The Common ◽  
Deep Vein ◽  
Removal Technique ◽  
Loop Snare

Caval filters are placed in the inferior vena cava (IVC) to prevent pulmonary thromboembolism in patients with deep vein thrombosis. If there is no indication for thrombo-embolic risk prevention, the filter can be removed to reduce potential filter-related complications. Advanced endovascular techniques are frequently used to retrieve IVC filters. We describe an alternative filter-removal technique for use when standard techniques are not practicable. In our method, the filter hook is embedded within the IVC wall. To retrieve it, a long introducer is inserted; a guidewire and the "loop snare" retrieval system are then advanced through it with a coaxial system and positioned below the filter at the level of the common iliac vein confluence. The guidewire is then passed through the loop, creating a "sling" around the filter which allows the application of traction from the bottom upwards, releasing the hook from the wall. The loop is then held under tension with the filter aligned in the IVC lumen, and the introducer is advanced distally to completely cover the filter, allowing complete retrieval of the filter without damaging the vessel walls. This modified Sling technique is a safe and feasible method for complicated IVC filter retrieval.

scholarly journals May-Thurner Syndrome with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Lori Jia ◽  
Jason Alexander ◽  
Nedaa Skeik
Keyword(s):  
Vena Cava ◽  
Iliac Vein ◽  
Postthrombotic Syndrome ◽  
Common Iliac Vein ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Venous Outflow Obstruction ◽  
Angioplasty And Stenting ◽  
Deep Vein

May-Thurner syndrome (MTS) is a venous outflow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.

Compression of the right iliac vein in asymptomatic subjects and patients with iliofemoral deep vein thrombosis

2016 ◽  
Vol 31 (7) ◽  
pp. 471-480 ◽  
Author(s):  
Feng Chen ◽  
Jun Deng ◽  
Xiao M Hu ◽  
Wei M Zhou
Keyword(s):  
Computed Tomography ◽  
Deep Vein Thrombosis ◽  
Iliac Artery ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Computed Tomography Images ◽  
Iliac Vein Compression ◽  
The Right ◽  
Asymptomatic Subjects ◽  
Deep Vein

Objective To evaluate right iliac vein and left iliac vein compression in asymptomatic subjects, right-sided and left-sided iliofemoral deep vein thrombosis patients. Methods A retrospective analysis of records and computed tomography images was conducted in 200 asymptomatic subjects (male:female, 100:100). A prospective analysis was conducted in 79 consecutive deep vein thrombosis patients (left:right deep vein thrombosis, 47:32) who had undergone contrast-enhanced computed tomography examination. The minor diameter and percentage compression of the iliac vein were evaluated. Results In asymptomatic subjects, 13.5% had right iliac vein compression >50%, 2.0% had right iliac vein compression >70%, mean compression was 23.48%; 45.0% had left iliac vein compression >50% and 17.0% had left iliac vein compression >70%, mean compression was 47.58%. Right iliac vein sandwiched between the right external iliac artery and the right internal iliac artery was the most common compression pattern (59.26%). Males had higher right iliac vein compression than the females (male:female, 26.29%:20.68%, P < 0.001). Mean percentage compression of the right iliac vein was higher in right deep vein thrombosis patients than in left deep vein thrombosis patients (right:left deep vein thrombosis, 48.54%:22.29%, P < 0.001). Conclusion Similar to left iliac vein compression, right iliac vein compression was a frequent imaging finding in CT and represented a normal anatomic pattern. Right deep vein thrombosis patients had more serious right iliac vein compression than left deep vein thrombosis patients, and further research is required on the association of right iliac vein compression with right iliofemoral deep vein thrombosis.

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