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 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.

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.

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 Percutaneous Thrombus Removal in COVID-19–Infected Patient with Pulmonary Embolism

2021 ◽  
Vol 17 (2) ◽  
pp. e33-e36
Author(s):  
Angelo Nascimbene ◽  
Sukhdeep Basra ◽  
Kha Dinh ◽  
Jayeshkumar Patel ◽  
Igor Gregoric ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Percutaneous Treatment ◽  
Vein Thrombosis ◽  
Left Lower Extremity ◽  
Transcatheter Aortic Valve ◽  
Thrombus Removal ◽  
The Right ◽  
In Transit ◽  
Deep Vein ◽  
Large Clot

We present a case describing the use of the AngioVac system (AngioDynamics, Inc.) and SENTINEL™ cerebral protection system (SCPS; Boston Scientific) in a patient with COVID-19 who initially presented with a large deep-vein thrombosis of the left lower extremity, complicated by a pulmonary embolism. Although he initially improved with systemic alteplase, he later developed a second large clot diagnosed in transit in the right atrium. Within 12 hours from initial thrombolysis, this large clot wedged across an incidental patent foramen ovale (PFO), the atrial septum, and the cavotricuspid annulus. We emergently performed a percutaneous clot extraction with preemptive placement of the SCPS in anticipation of cardioembolic phenomenon. A large (> 10 cm) clot was extracted without complication, and the patient was discharged home. The combined use of SCPS and AngioVac in this case suggests a potential role for percutaneous treatment of severe and consequential thromboembolic disease, especially in patients with a PFO, and may be considered as an alternative and less-invasive option in patients with COVID-19. While cerebral embolic protection devices are approved for and widely used in transcatheter aortic valve replacement procedures, there is a theoretical benefit for use in percutaneous thrombolectomies as well.

scholarly journals Major orthopedic surgery and its correlation with Cockett syndrome

2019 ◽  
Vol 13 (3) ◽  
pp. 212-6
Author(s):  
Raffael Marum Bachir ◽  
Inácio Diogo Asaumi ◽  
Donato Lo Turco ◽  
Fabio Luiz Kiyan
Keyword(s):  
Ligament Reconstruction ◽  
Iliac Vein ◽  
Level Of Evidence ◽  
Pes Cavus ◽  
Vein Thrombosis ◽  
Ankle Ligament ◽  
Major Orthopedic Surgery ◽  
Iliac Vein Compression Syndrome ◽  
The Right ◽  
Deep Vein

We report the case of a 42-year-old female patient complaining of pain in the right foot and repetitive sprains for 2 years who underwent surgical repair of pes cavus and ankle ligament reconstruction. Examination images (radiography, nuclear magnetic resonance, and ultrasound), postoperative (PO) period and progression to deep vein thrombosis are presented and discussed, as well as the resolution of this condition by endovascular surgery with angioplasty and stent implantation after suspicion of iliac vein compression syndrome caused by the contralateral iliac artery, known as Cockett syndrome. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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.

Diagnosis and resection of a giant ovarian cyst presenting in a young patient with contralateral back pain and lower limb deep vein thrombosis

2021 ◽  
Vol 14 (3) ◽  
pp. e239673
Author(s):  
Duranka Perera ◽  
Anita K Bolina ◽  
Nazneen Hoque ◽  
Khalil Razvi
Keyword(s):  
Deep Vein Thrombosis ◽  
Back Pain ◽  
Ovarian Cyst ◽  
Vena Cava ◽  
Large Mass ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
The Right ◽  
Deep Vein

We present a case of a giant ovarian cyst in a 20-year-old woman who presented atypically at our Emergency Department with left-sided back pain followed by acute left leg swelling. Blood tests showed significantly raised C-Reactive Protein and D-Dimer. CT-Abdomen-Pelvis demonstrated a large mass in the region of the right ovary with suspicious heterogeneous filling defects in the left external iliac vein, confirmed as a left-sided deep-vein thrombosis on ultrasound Doppler. MRI revealed the lesion to be cystic and the deep venous thrombosis was treated with twice-daily Clexane. Prior to removal of the cyst, an Inferior Vena Cava Filter was placed to reduce thromboembolic risk. The cyst was resected without complication and the postoperative period was uneventful. This case occurred while face-to-face services were limited by COVID-19 and illustrates the need for robust systemic measures to safeguard patients against the emergency sequelae of insidious gynaecological pathology.

scholarly journals Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Nelson Oliveira ◽  
Emanuel Dias ◽  
Ricardo Lima ◽  
Fernando Oliveira ◽  
Isabel Cássio
Keyword(s):  
Deep Vein Thrombosis ◽  
Vena Cava ◽  
Young Patients ◽  
Iliac Vein ◽  
Definitive Diagnosis ◽  
Systemic Thrombolysis ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
The Right ◽  
Deep Vein

Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging.Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation.Phlegmasia alba dolensinstalled progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy.Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

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.

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