May-Thurner Syndrome: A Case Report

Abstract

May-Thurner Syndrome (MTS) or iliac vein compression syndrome is caused by compression of the left common iliac vein by the right common iliac artery. This obstruction may cause leg swelling, varicosities, deep venous thrombosis, chronic venous stasis ulcers, or more serious complications, such as pulmonary embolism. Iliac vein compression can be assessed with computed tomography (CT) and iliac venography. The goals of treatment are to reduce symptoms and to reduce the risk of complications. Stent placement is an alternative method to a direct surgical approach. We present a case of MTS, treated with stent placement. Key Words: Iliac vein compression, May-Thurner Syndrome ÖzetMay-Thurner sendromu veya iliak ven kompresyon sendromu sol ana iliak venin sol ana iliak arter tarafından kompresyonu sonucu oluşur. Vendeki obstrüksiyon sonucu bacakta şişlik, varis, derin ven trombozu, kronik venöz staz ülserleri veya pulmoner embolizm gibi daha ciddi komplikasyonlar gelişebilir. İliak ven kompresyonu bilgisayarlı tomografi ve iliak venografi ile değerlendirilebilir. Tedavide amaç semptomları ve komplikasyon riskini azaltmaktır. Stent uygulaması cerrahi metoda alternatif bir yöntemdir. Yazımızda stent uygulaması yapılan bir MTS olgusunu sunulmaktadır.

May‐Thurner syndrome: History of understanding and need for defining population prevalence

“…24,41,65 However, venography is typically not performed unless thrombolysis is anticipated, owing to its invasive nature and postprocedural complications (eg, phlebitis). 66 Besides venography, other imaging techniques, such as multidetector computed tomography (CT) scans, 15,41,[67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83] magnetic resonance venography (MRV), 23,60,[84][85][86][87] and intravascular ultrasonography, 16,[88][89][90][91][92][93] have been used to image iliac venous compression and are described in Table 2.…”

An Unusual Presentation of Deep Vein Thrombosis

“…In chronic iliofemoral occlusion, where CDT cannot be considered, surgical intervention is advised. The procedure includes vein patch angioplasty, intraluminal band excision, division and relocation of the right common iliac artery behind the left common femoral vein, and creation of a vein graft bypass between the contralateral saphenous and ipsilateral common femoral veins where a temporary arteriovenous fistula is created [5] .…”

May-Thurner Syndrome – Diagnostic and therapeutic dilemmas (RCD code: I-1D.2)

“…It is estimated to be responsible for 2-5% of lower extremity venous disorders [1]. Other names for this disease include iliac vein compression syndrome, Cockett syndrome or iliocaval compression syndrome [1]. Its most common variant is caused by right common iliac artery compression of the left common iliac vein.…”

“…The vast majority of patients with this syndrome have no symptoms [2,3]. Symptomatic MTS occurs 5 times more often in women, usually in their 20 s and 40 s [1,2]. Chronic pulsations of the overriding right iliac artery lead to collagen and elastin accumulation, extensive intimal hypertrophy of the vein, impaired venous return and ultimately to venous thrombosis [1,3].…”

“…Symptomatic MTS occurs 5 times more often in women, usually in their 20 s and 40 s [1,2]. Chronic pulsations of the overriding right iliac artery lead to collagen and elastin accumulation, extensive intimal hypertrophy of the vein, impaired venous return and ultimately to venous thrombosis [1,3]. Situations such as prolonged immobilisation, cancer, surgery, pregnancy, oral contraceptive use, dehydration, and infections may induce blood clot Figure 3.…”