Intravascular ultrasonographic findings in May‐Thurner syndrome (iliac vein compression syndrome).

Abstract

The objective of this series was to describe the findings in 2 types of iliac vein compression syndrome on intravascular ultrasonography. We conducted a retrospective review of the intravascular ultrasonographic findings in 2 patients with iliac vein compression syndrome due to 2 different types of venous spur and correlated those findings with the contrastenhanced venographic findings. Intravascular ultrasonography allowed differentiation of the 2 different types of iliac vein compression syndrome in analogy to the venographic classification. Both cases had compression of the left common iliac vein between the right common iliac artery and the vertebral bodies. In addition, hyperechogenic eccentric wall thickening, the presence of multiple vascular channels separated by hyperechogenic structures, and the presence of sequelae of deep venous thrombosis such as synechiae and organized thrombus can be seen on intravascular ultrasonography. The ability to perform exact measurements of the venous dimensions is an added benefit of intravascular ultrasonography. Intravascular ultrasonography can assist in the diagnosis and classification of iliac vein compression syndrome, allows assessment of its complications, and can be potentially helpful for planning endovascular treatment.

Venous compression syndromes: clinical features, imaging findings and management

“…Surgical treatment options can also be offered, which include thrombectomy of the iliofemoral veins with iliac venous reconstruction [52]. Another surgical treatment method that has been described is placement of a cross-femoral venous bypass graft (Palma procedure) [53,54].…”

“…In the presence of acute DVT, the standard therapy is anticoagulation with compression stockings. Currently, endovascular thrombolysis with treatment of the venous compression with stents is advocated [51,52]. Endovascular therapy involves catheter-directed thrombolysis with the use of pharmacological agents (tissue plasminogen activator) and/or various mechanical thrombectomy devices.…”

Iliac vein compression syndrome: Clinical, imaging and pathologic findings

“…IVUS, using either a 12.5-MHz or 20-MHz ultrasound transducer, can accurately determine LCIV vessel size and morphology, and can verify the presence of MTS anatomy [10,25,26] . Knipp et al [6] utilized IVUS to confirm a diagnosis of MTS in 36 out of 58 patients; (62.1%) and defined the IVUS criteria for an MTS diagnosis as the lack of an evident venous lumen proximate to the IVUS catheter.…”

Endovascular Treatment of Iliac Vein Compression (May-Thurner) Syndrome: Angioplasty and Stenting with or without Manual Aspiration Thrombectomy and Catheter-Directed Thrombolysis

“…CDU is the fi rst-line method used to screen patients with CVI disorders, and can detect DVT. 17,18) However, the technique cannot accurately identify venous spurs or compression of the LCIV. If MTS is suspected in patients subjected to ultrasonography, cross-sectional imaging (CT venography, magnetic resonance angiography) or venography should be used to accurately visualize the pelvic region.…”