Unusual Case of Right-Sided May-Thurner Syndrome and Review of Its Management

Vascular ◽  
2006 ◽  
Vol 14 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Renee M. Burke ◽  
Sunil S. Rayan ◽  
Karthikeshwar Kasirajan ◽  
Elliot L. Chaikof ◽  
Ross Milner
Keyword(s):  
Inferior Vena Cava ◽  
Iliac Artery ◽  
Unusual Case ◽  
Inferior Vena ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Endoluminal Stent

May-Thurner syndrome is a phenomenon commonly described as an acquired stenosis of the left common iliac vein as a result of right common iliac artery compression. We report an unusual case of right-sided May-Thurner syndrome in a patient found to have a left-sided inferior vena cava. We also review the management of this patient using angioplasty, intraoperative thrombolysis, and endoluminal stent placement.

Unusual Case of Parkes Weber Syndrome with Aneurysm of the Left Common Iliac Vein and Thrombus in Inferior Vena Cava

2015 ◽  
Vol 29 (7) ◽  
pp. 1450.e17-1450.e19 ◽  
Author(s):  
Igor Banzic ◽  
Milos Brankovic ◽  
Igor Koncar ◽  
Nikola Ilic ◽  
Lazar Davidovic
Keyword(s):  
Inferior Vena Cava ◽  
Unusual Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Weber Syndrome

Selection of retroperitoneal access during intervertebral disc endoprosthesis in lumbar spine

2021 ◽  
Vol 23 (1) ◽  
pp. 73-80
Author(s):  
Maxim A. Priymak ◽  
Ivan A. Kruglov ◽  
Alexei I. Gaivoronski ◽  
Maksim N. Kravtsov ◽  
Gennady G. Bulyshchenko
Keyword(s):  
Lumbar Spine ◽  
Inferior Vena Cava ◽  
Intervertebral Disc ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Intervertebral Discs ◽  
Skin Incision ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein

The morphometric parameters and surgical areas of risk of retroperitoneal approach were studied for endoprosthetics of intervertebral discs in the lumbar spine to reduce trauma and reduce the risk of complications. The study included 110 patients operated on in the period from 2017 to 2020 (72 men, 38 women) in the neurosurgical department of the 1586 Military Clinical Hospital. The average age of the patients was 44.9 15.4 years. According to the localization of access to the lumbar spine, the patients were distributed as follows: LIIILIV 8 (7.3%), LIVLV 46 (41.7%), LVSI 56 (51%). It was found that, for the intervertebral disc LV SI, the length of the skin incision was 92.5 (80; 100) mm, the length of the surgical wound was 80 (80; 110) mm, the thickness of the subcutaneous fat layer was 30 (15; 40) mm, the depth of the wound was to the spine 85 (70; 120) mm, the depth of the wound to the spinal canal 125 (107.5; 152.5) mm, the angle of operation in the horizontal plane at the level of the spine 52 (47; 59.5) degrees. On the basis of the anthropometric data of patients, the optimal length of the skin incision was determined for performing the retroperitoneal approach (120 mm for level LIIILIV, 100 mm for level LIVLV). Three variants of the inferior vena cava bifurcation have been identified for different levels of intervertebral discs in the lumbar spine: high bifurcation, left common iliac vein mainly overlaps the left half of the LIVLV intervertebral disc and does not overlap the LVSI intervertebral disc; middle bifurcation, left common iliac vein overlaps the central part of the intervertebral discs LIVLV and LVSI; low bifurcation, inferior vena cava overlaps the right side of the intervertebral disc LIVLV, inferior vena cava and left common iliac vein completely overlap the intervertebral disc LVSI. The data obtained can be used when planning retroperitoneal access to the lumbar spine in order to reduce the trauma of the operation.

scholarly journals ANOMALOUS COMMUNICATION BETWEEN RIGHT INTERNAL ILIAC VEIN AND LEFT COMMON ILIAC VEIN - A CASE REPORT

2014 ◽  
Vol 04 (03) ◽  
pp. 119-120
Author(s):  
Huban Thomas R. ◽  
Prakashbabu B. ◽  
Radhakrishnan P.
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lumbar Vertebra ◽  
Iliac Vein ◽  
The Body ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac

AbstractInferior vena cava (IVC) is formed by the union of the common iliac veins anterior to the body of the fifth lumbar vertebra, a little to its right side. It conveys blood to the right atrium from all the structures below the diaphragm. During routine educational dissection for medical undergraduates, we have come across a case of an anomalous communication between right internal iliac vein and left common iliac vein and a variation in the formation of inferior vena cava in a 55-year-old male cadaver. Due to its complex embryogenesis and relationship with other abdominal and thoracic structures, IVC may develop abnormally. These anatomical variations are often clinically silent and discovered incidentally. Knowledge of these variations may be helpful to clinicians and anatomists during surgical exploration, atypical clinical presentations and cadaveric findings.

scholarly journals Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature

2017 ◽  
Vol 63 (4) ◽  
pp. 190-193
Author(s):  
Ioan Tilea ◽  
Anca Elena Negovan ◽  
Cristina Maria Tatar ◽  
Elena Ardeleanu ◽  
Radu Mircea Neagoe ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Inferior Vena Cava ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein

AbstractIntroduction: Extrahepatic portal vein thrombosis (EPVT) is the most frequent cause that leads to portal hypertension in non-cirrhotic patients. This condition is related to systemic and local risk factors (such as inflammatory lesions, injuries to portal venous system by surgery, vascular procedures).Case presentation: A case of extended extrahepatic portal vein thrombosis and simultaneous thrombosis of left common iliac vein and inferior vena cava, appeared after abdominal surgery in a hypertensive, diabetic, 50 y.o. man is presented. An acute episode of abdominal pain was interpreted as an emergency and a surgical (initially laparoscopic and then open) procedure was planned in order to perform an appendectomy. Discharge diagnosis was hemoperitoneum secondary to iatrogenic rupture of sigmoid mesocolon provoked by trocar manipulation. Repeated imaging studies performed later revealed the thrombosis of portal vein with extension into right portal branch associated with superior mesenteric thrombosis and free-floating thrombus into left common iliac vein extended towards inferior vena cava. Surgical manoeuvres are considered as triggers of these thrombotic events. After 4 weeks of parenteral anticoagulation a partial recanalization of thrombi was identified, without bleedings.Conclusions: Acute EPVT needs a carefully management. Case is linked to abdominal surgery and requires prolonged anticoagulation related to simultaneous portal and iliac vein thrombosis. Associated conditions (hypertension and diabetes mellitus) must have an appropriate approach. After our knowledge this is the first case published in literature.

Our clinical experiences of vascular injuries due to lumbar disc surgeries

Vascular ◽  
2021 ◽  
pp. 170853812110216
Author(s):  
Mehmet Ali Kaygin ◽  
Umit Halici
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Lumbar Disc ◽  
Vena Cava ◽  
Lateral Wall ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Artery ◽  
Left Common Iliac Vein ◽  
Graft Interposition

Objectives We aimed to evaluate emergency vascular complications of the lumbar disc reconstructive surgery in this study. Method Between March 2006 and February 2020, nine patients (six males and three females; mean age: 53.4 ± 9.6 years; range: 38–64 years) who underwent emergent vascular intervention during lumbar spinal disc reconstructive surgery in our clinic were included in this retrospective study. Result The left common iliac artery injury, the left common iliac artery and left common iliac vein injuries, bilateral common iliac artery and abdominal aortic injuries, and vena cava inferior injury with left common iliac vein and right common iliac vein injuries were detected in two, three, two, and two patients, respectively. In addition, 16 mm Dacron tube graft interposition and graft patch plasty were performed in one and two patients who had an abdominal aortic injury, respectively. Also, 8 mm polytetrafluoroethylene straight graft interposition was performed in two patients with left common iliac artery injury, and lateral wall repair was performed in other patients. Graft patch plasty and 8 mm polytetrafluoroethylene graft interposition were performed in one patient with vena cava inferior injury and left common iliac vein injury, respectively. Also, lateral wall repair was performed in other patients with venous injuries. Deep venous thrombosis had developed in three patients, and one patient of these had a pulmonary embolism. Conclusion The incidence of vascular injury after the lumbar disc surgery is relatively low; however, the emergency vascular operation should be performed as soon as possible.

scholarly journals A rare case of May-Thurner-like syndrome in an elderly lady

2014 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Kapil Sahnan ◽  
Chris Pui Yan Yee ◽  
Robert Hywel Thomas ◽  
Kaji Sritharan
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Imaging Modality ◽  
Lumbar Vertebrae ◽  
Kidney Injury ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Extrinsic Compression ◽  
Duplex Imaging

An elderly lady presented with decreased mobility, sputum production and intermittent confusion. She was treated for chest sepsis, fast atrial fibrillation, and acute kidney injury, and also noted to have a swollen left leg. Venous duplex imaging showed extensive thrombus within the left common iliac, left external iliac and left common femoral veins. A CT Venogram showed compression of the left common iliac vein between an osteophyte at L5 and a calcified ipsilateral common iliac artery. It also showed a pelvic kidney with an extra renal pelvis and large renal cyst which was indirectly contributing to venous compression by splinting the left iliac artery. A decision was made after discussion at the Vascular MDT that the patient was not fit enough for surgery and to manage her medically with anticoagulation. Discussion: Proximal DVT’s are rarer than distal thrombosis, but have similar causes. One of the rarer causes of proximal DVT is May-Thurner syndrome and its variants known collectively as non-thrombotic iliac vein lesions. May-Thurner originally described DVT formation caused by extrinsic compression of the left common iliac vein between the overriding contralateral (right) common iliac artery and adjacent lumbar vertebrae. The best imaging modality is a CT Venogram. Duplex ultrasonography can be used, although it can be difficult to visualize the iliac veins. The mainstay of management is surgical thrombectomy, or thrombolysis, followed by stenting of the affected vessel. However, if intervention is not appropriate, then it can be managed medically with anticoagulation. 

Iliocaval Compression Syndrome

1987 ◽  
Vol 2 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Syde A. Taheri ◽  
Paul Nowakowski ◽  
David Pendergast ◽  
Julie Cullen ◽  
Steve Pisano ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
Compression Syndrome ◽  
Extrinsic Compression ◽  
The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

A RARE CASE OF MAY- THURNER SYNDROME

2021 ◽  
pp. 17-19
Author(s):  
B. Santhi ◽  
Manigandan Manigandan ◽  
Nishok Nishok
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Rare Case ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Middle Aged ◽  
Unique Case ◽  
Left Common Iliac Vein ◽  
Left Lower Limb

May-Thurner syndrome (MTS) is a venous outow 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.We report a unique case of a 25 -year-old male who presented with MTS-related multiple varicosities in left lower limb.

scholarly journals Late-Onset Nonthrombotic Left Common Iliac Vein Compression Secondary to Degenerative Lumbar Disc: A Case Report of May-Thurner Variant

2018 ◽  
Vol 53 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Salman Khalid ◽  
Young Jin Youn ◽  
Michael Azrin ◽  
Juyong Lee
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Late Onset ◽  
Multimodality Imaging ◽  
Lumbar Disc ◽  
Lumbar Vertebrae ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Extrinsic Compression

May-Thurner syndrome (MTS) refers to venous outflow obstruction caused by extrinsic compression of the left common iliac vein (LCIV) by the overlying pulsatile right common iliac artery against lumbar vertebrae. The classic clinical presentation is acute unilateral left leg painful swelling due to deep venous thrombosis in a young woman in the second or third decade of life. We present a case of a 66-year-old woman who presented with late-onset left leg swelling caused by nonthrombotic venous hypertension due to degenerative lumbar disc bulge leading to LCIV compression against the left common iliac artery which was confirmed by computed tomography and intravascular ultrasound. Our case highlights the importance of high index of suspicion for MTS in elderly patients with unilateral leg swelling and the importance of multimodality imaging for understanding the mechanism and appropriate treatment of MTS.

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