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

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.

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

VASA ◽

10.1024/0301-1526/a000928 ◽

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.

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

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515598700 ◽

2016 ◽

Vol 31 (7) ◽

pp. 471-480 ◽

Cited By ~ 2

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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Ilio-Femoral Deep Vein Thrombosis Secondary to May-Thurner Syndrome With Ipsilateral Lower Limb Arterio-Venous Graft In-Situ

Vascular and Endovascular Surgery ◽

10.1177/1538574421994782 ◽

2021 ◽

pp. 153857442199478

Author(s):

Brjan Kaiji Betzler ◽

Li zhang ◽

Kai Siang Chan ◽

Enming Yong ◽

Ivan Kuang Hsin Huang ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Duplex Ultrasound ◽

Iliac Vein ◽

Common Iliac Vein ◽

Arteriovenous Graft ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Deep Vein

Ilio-femoral deep vein thrombosis (DVT) is rare in patients with lower limb arterio-venous grafts due to a state of high blood flow. May-Thurner syndrome (MTS) is an anomaly where the left common iliac vein is compressed by the right common iliac artery. We present a rare case of ilio-femoral deep vein thrombosis in a patient with May-Thurner Syndrome and an underlying arteriovenous graft in-situ who presented with acute lower limb swelling. The patient underwent catheter-directed thrombolysis, pharmaco-mechanical thrombectomy, venoplasty and iliac vein stenting. Follow-up surveillance duplex ultrasound showed patency of the iliac vein stent and arteriovenous graft at 1-year postoperatively.

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Compression of the Left Common Iliac Vein in Asymptomatic Subjects and Patients with Left Iliofemoral Deep Vein Thrombosis

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2007.09.007 ◽

2008 ◽

Vol 19 (3) ◽

pp. 366-370 ◽

Cited By ~ 60

Author(s):

Levent Oguzkurt ◽

Ugur Ozkan ◽

Serife Ulusan ◽

Zafer Koc ◽

Fahri Tercan

Keyword(s):

Deep Vein Thrombosis ◽

Iliac Vein ◽

Common Iliac Vein ◽

Vein Thrombosis ◽

Left Common Iliac Vein ◽

Asymptomatic Subjects ◽

Deep Vein

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Compression of left common iliac vein is independently associated with left-sided deep vein thrombosis

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2013.05.001 ◽

2013 ◽

Vol 1 (4) ◽

pp. 364-369 ◽

Cited By ~ 6

Author(s):

Feng Chen ◽

Jun Den ◽

Qing Wen Yuan ◽

Wei Min Zhou ◽

Ji Xin Xiong ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Iliac Vein ◽

Common Iliac Vein ◽

Vein Thrombosis ◽

Left Common Iliac Vein ◽

Deep Vein

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

Case Reports in Vascular Medicine ◽

10.1155/2019/7079307 ◽

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.

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

Malawi Medical Journal ◽

10.4314/mmj.v31i3.12 ◽

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.

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