scholarly journals Endovascular correction of venogenic erectile dysfunction in May–Thurner syndrome (clinical case)

2019 ◽  
Vol 20 (4) ◽  
pp. 45-51
Author(s):  
E. A. Povelitsa ◽  
A. V. Bystrenkov ◽  
A. M. Shesternya ◽  
O. V. Parkhomenko
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Case ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Venous Plexus ◽  
Common Femoral Vein ◽  
Left Common Iliac Vein ◽  
The Right ◽  
Deep Vein

Introduction. Secondary varicose small pelvic veins with the development of chronic venous insufficiency due to obstruction of the magistral venous vessels, in particular, the left common iliac vein and the right common iliac artery (May–Thurner syndrome), occupy a special place in the structure of the causes of venogenic erectile dysfunction (ED).The study objective is to present the clinical case of arteriovenous conflict (May–Thurner syndrome), leading to the development of secondary varicose small pelvic veins in men and venogenic ED, as well as modern methods of its verification and endovascular surgical repair.Clinical case. A clinical case of successful endovascular correction of venogenic ED is presented. The patient is diagnosed with: May– Thurner syndrome. Pelvic varicose disease С3 (according to CEAP Classification). Condition after endovascular balloon angioplasty and stenting of the left common iliac vein. Bilateral varicocele. Condition after bilateral varicocelectomy in 2018. Severe venogenic ED (pathological venous drainage, proximal type, International Index of Erectile Function (v. 5) – 12 points; Er3 according to the Unem Scale) in accordance with the Comprehensive Classification System for Chronic Venous Disorders. On July 24, 2019 endovascular occlusion of the Santorini’s plexus veins was performed with the installation of occlusion spirals in their lumen according to Gianturco. In order to provide visualization of the veins in the Santorini’s plexus, given the impossibility of cannulation of the deep vein of the penis, bilateral symmetrical cannulation of the cavernous bodies of the penis was carried out to perform cavernosophlebography. The left common iliac vein was catheterized according to the Crossover technique. Under phlebography control we ensured that the stent in the common iliac vein passed without signs of loss of its lumen. The internal pudental vein on the left was selectively catheterized. Hydrophilic guidewire was introduced through the veins of the periprostatic plexus into the right internal pudental vein. Selective catheterization of the periprostatic venous plexus was not possible due to pronounced tortuosity, valve flaps of the veins and small diameter of the catheterized veins. It was decided to pass the guidewire further through the right iliac vein system with access to the inferior vena cava. Further, the guidewire was again transferred to the left common iliac vein (double crossover). The left common femoral vein was punctured followed by the placement of 5 Fr introducer sheath according to Seldinger. The guidewire tip was fixed by the loop in the left common iliac vein, then captured and brought out through the introducer in the left common femoral vein. A catheter Сobra15 Fr was inserted through a crossover guide from the left common femoral vein into the right internal iliac vein and further into the periostatic venous plexus. Gradually veins of the Santorini’s plexus were selectively catheterized followed by Gianturco coils embolization.Conclusion. The first choice surgery for verified proximal type ED is endovascular occlusion of the veins in the Santorini’s plexus through the deep vein of the penis, which allows to change the hemodynamics in the penis and provide sufficient erection without resorting to endofalloprosthesis of the penis. Single or double-sided transfemoral access is suggested for patients when access through the deep vein of the penis is rather challenging or absent. 

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.

Absence of the right iliac vein and an unusual connection between both common femoral veins

2013 ◽  
Vol 28 (3) ◽  
pp. 162-164 ◽  
Author(s):  
A Yahyayev ◽  
M Bulakci ◽  
E Yilmaz ◽  
A Ucar ◽  
O A Sayin ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Femoral Vein ◽  
Clinical Importance ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Fatty Tissue ◽  
Surgical Interventions ◽  
Common Femoral Vein ◽  
Venous Structure ◽  
The Right

The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient's life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage.

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.

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.

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.

Anomalous course of the left common iliac vein anterior to the right common iliac artery with resultant May-Thurner syndrome

2019 ◽  
Vol 7 (3) ◽  
pp. 450-451
Author(s):  
Arash Fereydooni ◽  
Christine Deyholos ◽  
Nariman Nezami ◽  
Joshua R. Feler ◽  
Hamid Mojibian ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
The Right

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.

Unusual cases of right-sided and left-sided May–Thurner syndrome

2014 ◽  
Vol 25 (4) ◽  
pp. 797-799 ◽  
Author(s):  
I. B. Vijayalakshmi ◽  
H. S. Natraj Setty ◽  
Chitra Narasimhan
Keyword(s):  
Aortic Stenosis ◽  
Rare Case ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Rare Clinical Entity ◽  
Venous Obstruction ◽  
Left Common Iliac Vein ◽  
Left Lower Extremity ◽  
The Right

AbstractMay–Thurner syndrome is a rare clinical entity involving venous obstruction of the left lower extremity. The May–Thurner syndrome is a phenomenon commonly described as an acquired stenosis of the left common iliac vein secondary to compression of the left common iliac vein between the right common iliac artery and the underlying vertebral body. We report one case of May–Thurner syndrome, and another rare case of reverse May–Thurner syndrome, incidently detected during intervention, in a case of aortic stenosis and mitral stenosis with dextrocardia and situs inversus.

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