Left iliac venous thrombosis caused by venous spur: Treatment with thrombectomy and stent implantation

Mickley, V.; Schwagierek, Robert; Rilinger, N.; Görich, Johannes; Sunder‐Plassmann, L.

doi:10.1016/s0741-5214(98)70135-1

Cited by 158 publications

(121 citation statements)

References 18 publications

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“…13) [49]: 1) периоперационную флебографию, как правило, показывающую коллатеральное кровообраще-ние левой общей подвздошной вены под правой общей подвздошной артерией;…”

Section: анатомические варианты подвздошной ве-нозной компрессииunclassified

Arteryovenous conflicts in men with urological pathology

Kapto

Александрович²

2018

Urolog vedom

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For the present study, we analyzed previously known and current data on arteriovenous conflicts in men from the perspective of urologists and andrologists. The least studied and controversial decision-making position was for iliac venous compression and pelvic varicose veins in men. The data testify to the need to revise the traditional and generally accepted positions for managing varicocele. (For citation: Kapto AA. Arteryovenous conflicts in men with urological pathology. Urologicheskie vedomosti. 2018;8(2):53-63. doi: 10.17816/uroved8253-63).

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Section: анатомические варианты подвздошной ве-нозной компрессииunclassified

Arteryovenous conflicts in men with urological pathology

Kapto

Александрович²

2018

Urolog vedom

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“…Por ser um procedimento relativamente novo, ainda faz-se necessário um maior seguimento dos pacientes e maiores estudos relacionados ao uso da técnica endovascular para o segmento venoso. Porém, a evolução do caso exposto, bem como a revisão da literatura, apontam para uma utilização crescente desta técnica 1,2,3,[7][8][9]11,13,20,22,23 .…”

Section: Conclusãounclassified

“…Recentemente, com o advento da cirurgia endovascular, uma nova estratégia terapêu-tica menos invasiva e com bons resultados foi instituída: a angioplastia com balão e colocação de stent 1,12,13 . Este artigo tem a finalidade de relatar o caso de uma paciente com diagnóstico de Síndrome de May-Thurner, tratada com sucesso por angioplastia venosa por balão e colocação de stent.…”

Section: Introductionunclassified

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Tratamento endovascular da síndrome de compressão da veia ilíaca (May-Thurner): relato de caso

Júnior

Neves

Fontes³

et al. 2011

J. vasc. bras.

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IntroduçãoA síndrome de compressão da veia ilíaca, também conhecida como Síndrome de May-Thurner, é uma doença pouco comum causada pela compressão da veia ilíaca esquerda pela artéria ilíaca direita, proporcionando uma sé-rie de sintomas dependendo do grau de compressão, entre eles: edema assimétrico de membro inferior esquerdo, dor, surgimento de varizes e trombose venosa [1][2][3] . Esta síndrome foi descrita pela primeira vez em 1956, por May e Thurner, a partir do estudo de cadáveres, como variações anatômicas da veia ilíaca esquerda proporcionando uma interrupção do fluxo venoso 4,5,[7][8][9] . Lesões vasculares fibrosas chamadas de spurs foram encontradas no nível em que a artéria ilía-ca direita comprimia a veia ilíaca esquerda contra a quinta vértebra lombar 5,10 . Em 1965, Cockett e Thomas relataram ResumoA Síndrome de May-Thurner é uma causa pouco comum de sinais e sintomas venosos relacionados ao membro inferior esquerdo. Esta síndrome é caracterizada pela compressão da veia ilíaca comum esquerda pela artéria ilíaca comum direita e, quando tal alteração anatômica causa sintomas que venham a prejudicar a qualidade de vida do paciente, existe a indicação de tratamento cirúrgico ou endovascular para correção desta alteração anatômica. Este artigo é o relato de um caso, no qual optou-se pelo tratamento endovascular com resultado satisfatório e as indicações, as nuances e os resultados esperados para esta técnica no tratamento da Síndrome de May-Thurner são discutidos. Foi concluído que, nesta síndrome, há eficácia do tratamento endovascular com melhora dos sintomas pela recanalização do sistema venoso, sem grandes riscos inerentes ao procedimento e com curto período de internação hospitalar.Palavras-chave: veia ilíaca; artéria ilíaca; varizes; edema; flebografia AbstractMay-Thurner Syndrome is an uncommon cause of venous symptoms and signs related to the left lower limb. It is characterized by compression of the left common iliac vein by the right common iliac artery and, when such anatomical change causes symptoms that may impair the patients' quality of life, surgical treatment is indicated. This article addresses a case of May-Thurner syndrome in which we opted for endovascular treatment with satisfactory outcome, as well as a discussion about indications, nuances, and expected results. We concluded that endovascular treatment is effective in treating this syndrome, for it resolves the symptoms by recanalization of the venous system with little risks during the procedure and with short hospital stay.

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“…6 Indeed, some authors specifically recommend stent placement in patients with May-Thurner syndrome to treat the compressed right iliac vein, ensure long-term venous patency, and prevent chronic venous insufficiency syndromes. 13,15,16 Although systemic thrombolysis is superior to anticoagulation alone in resolving thrombus, it carries the risk of major bleeding. However, observational data suggest that catheter-directed thrombolysis is more effective and less risky than systemic thrombolysis.…”

Section: Ovarian Cancer D Abdominal Aortic Aneurysm E May-thurner Smentioning

confidence: 99%

57-Year-Old Woman With Acute Lower Extremity Pain and Swelling

Coss

Mueller

2009

Mayo Clinic Proceedings

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A 57-year-old postmenopausal woman presented to our emergency department with a 1-day history of left leg pain, redness, and swelling. She reported no chest pain or shortness of breath. During the previous week, she made several car trips, each lasting 3 hours. Her medical history was remarkable for a left femoral and popliteal deep venous thrombosis (DVT) after breast reduction surgery during the previous year, which was treated with 1 week of subcutaneous low-molecular-weight heparin therapy and 6 months of oral warfarin therapy. She also had a history of hyperlipidemia, allergies, gastroesophageal reflux, and depression. She denied using tobacco or illicit drugs. Breast, cervical, and colon cancer screening were current and unremarkable. Daily oral medications were atorvastatin, sertraline, montelukast, and pantoprazole. She reported no family history of DVT.On arrival at the emergency department, the patient's vital signs were as follows: temperature, 36.8°C; blood pressure, 150/77 mm Hg; heart rate, 71 beats/min; respiratory rate, 18 breaths/min; and room air oxygen saturation, 93%. Physical examination revealed erythema, warmth, tenderness, and swelling of the entire left leg with intact distal pulses ( Figure 1). The right leg was unaffected. Laboratory tests revealed the following: white blood cell count, 9.3 × 10 9 /L; hemoglobin, 14.7 g/dL; platelets, 321 × 10 9 /L; creatinine, 0.7 mg/dL; activated partial thromboplastin time, 23 seconds; and international normalized ratio, 0.9. Which one of the following is the most likely diagnosis in our patient? a. Deep venous thrombosis b. Muscle strain c. Superficial thrombophlebitis d. Ruptured Baker cyst e. CellulitisDeep venous thrombosis is the most likely diagnosis given the prior DVT, recent car trips, and clinical findings. One can assess the probability of DVT by using the Modified Wells Clinical Score.1 One point each is given for clinical features, such as active cancer, paralysis or recent lower extremity immobilization, being bedridden for more than 3 days within the previous 4 weeks, localized tenderness along the deep venous system, whole leg swelling, calf swelling by more than 3 cm compared with the asymptomatic leg, pitting edema, collateral superficial veins, and previous DVT. Two points are subtracted when an alternative diagnosis is more likely than DVT. A score of 2 or more indicates that DVT is likely, whereas a score of 1 or less indicates that DVT is unlikely. Our patient's score was 2, indicating that DVT was likely.Muscle strain can mimic DVT; 40% of patients with suspected DVT but negative findings on contrast venography have muscle injury as the cause of lower extremity symptoms.2 Our patient, however, had not experienced a recent injury. Superficial thrombophlebitis (ie, acute inflammation of a superficial vein caused by a thrombosis) usually presents with a palpable cord, inconsistent with our patient's clinical findings. A ruptured Baker (popliteal) cyst can mimic DVT because it causes leg pain and swelling. However, a ruptured Bake...

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Left iliac venous thrombosis caused by venous spur: Treatment with thrombectomy and stent implantation

Cited by 158 publications

References 18 publications

Arteryovenous conflicts in men with urological pathology

Arteryovenous conflicts in men with urological pathology

Tratamento endovascular da síndrome de compressão da veia ilíaca (May-Thurner): relato de caso

57-Year-Old Woman With Acute Lower Extremity Pain and Swelling

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