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. 2016 Jan 31:12:19-28.
eCollection 2015 May-Aug.

What the young physician should know about May-Thurner syndrome

Donatella Narese  1 , Umberto Marcello Bracale  2 , Gaetano Vitale  2 , Massimo Porcellini  3 , Massimo Midiri  1 , Giancarlo Bracale  2
Affiliations

What the young physician should know about May-Thurner syndrome

Donatella Narese et al. Transl Med UniSa. .

Abstract

May-Thurner syndrome (MTS) is an anatomically variable condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine with subsequent development of a left deep vein thrombosis (DVT). Although this syndrome is rare, its true prevalence is likely underestimated. Mainly, clinical symptoms and signs include, but are not limited to, pain, swelling, venous stasis ulcers, skin pigmentation changes and post-thrombotic syndrome. Correct treatment is not well established and is based on clinical presentation. Staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement followed by angioplasty/stenting of the left iliac vein appears to be the best option in MTS patients with extensive DVT. The aim of this review is to present in a simple and didactic form all variable clinical presentations of MTS and to outline possible management within the current guidelines.

Keywords: DVT; May-Thurner Syndrome; endovascular treatment; medical education; thrombectomy.

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Figures

Fig. 1:
Fig. 1:
drawing showing left common iliac vein compression by right common iliac artery (morphologic type I).
Fig. 2:
Fig. 2:
drawing showing diffuse atrophy of left common iliac vein in May-Thurner Syndrome (morphologic type II).
Fig. 3:
Fig. 3:
drawing showing cordlike obliteration of left common iliac vein in May-Thurner Syndrome (morphologic type III)
Fig. 4a:
Fig. 4a:
MRI of 18 year-old women showing compression and thrombotic occlusion of the left iliac vein
Fig. 4b:
Fig. 4b:
Subtracted maximum intensity projection coronal post contrast MRI showing dilated left pelvic collaterals.
Fig. 5:
Fig. 5:
drawing showing Palma operation with autologous saphenous vein graft
Fig. 6:
Fig. 6:
drawing showing endovascular treatment with self-expanding stent placement in left common iliac vein
See this image and copyright information in PMC

References

    1. Cockett FB, Thomas ML. The iliac compression syndrome. Br J Surg. 1965;52(10):816–21. - PubMed
    1. Burke RM, Rayan SS, Kasirajan K, Chaikof EL, Milner R. Unusual case of right-sided May-Thurner syndrome and review of its management. Vascular. 2006;14(1):47–50. - PubMed
    1. Abboud G, Midulla M, Lions C, El Ngheoui Z, Gengler L, Martinelli T, Beregi JP. “Right-sided” May-Thurner syndrome. Cardiovasc Intervent Radiol. 2010;33(5):1056–9. - PubMed
    1. Virchow R. Uber die Erweiterung Kleiner Gefasse. Arch Path Anat. 1851;3:427.
    1. McMurrich JP. The occurrence of congenital adhesions in the common iliac veins, and their relation to thrombosis of the femoral and iliac veins. Am J Med Sci. 1908;135:342–6.

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