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. 2021 Aug 20:14:4705-4710.
doi: 10.2147/IJGM.S325231. eCollection 2021.

Treatment of May-Thurner's Syndrome and Associated Complications: A Multicenter Experience

Priscilla Sigua-Arce  1 , Ramy Mando  1 , Lisa Spencer  2 , Alexandra Halalau  1   2
Affiliations

Treatment of May-Thurner's Syndrome and Associated Complications: A Multicenter Experience

Priscilla Sigua-Arce et al. Int J Gen Med. .

Abstract

Objective: To assess the treatment options and associated complications in patients with May-Thurner's syndrome (MTS).

Methods: We retrospectively reviewed the charts of patients diagnosed with MTS. Thorough review was completed and data relevant to methods of diagnosis, treatment, complications, hospital readmission, and mortality were extracted from patient charts. The patients were followed for two years after diagnosis.

Results: Of the 47 patients identified as having "MTS", 32 (70%) were diagnosed formally with either magnetic resonance venography, computed tomography venography, or ultrasound. Two patients were excluded for insufficient availability of follow-up records. Mean age of the population included (N = 30) was 50.24 ±15.33 years and 83% (N = 25) had female gender. The majority (40%) of patients were treated with anticoagulation, thrombolysis, and stent placement, and 13.3% received a combination of anticoagulation, antiplatelet agent, thrombolysis, and stent placement. Overall, we found 28 patients (93%) who underwent endovascular stenting. However, 39.3% (11/28) had stent-related complications that included stent thrombosis, stenosis, and migration. One patient underwent open heart surgery for stent retrieval. Duration of anticoagulation therapy ranged from 6 months to lifelong. Two patients (6.7%) suffered major bleeds requiring transfusion. Fourteen patients (46.6%) developed post-thrombotic syndrome. Seven (23.3%) patients required MTS-related readmission within 30 days. No mortality was noted at two-year follow-up.

Conclusion: Although our study only included 30 patients, it was evident to us that there is no consensus in the management of MTS. Furthermore, endovascular stenting, which has a major role in the management of MTS, has complication rates that hover close to 40%. Further research is needed to help develop a standardized evidence-based approach in the management of MTS that ensures a decreased risk of immediate and long-term complications.

Keywords: May–Thurner syndrome; anticoagulation; complications; diagnosis; treatment.

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Conflict of interest statement

The authors have no conflicts of interest regarding this work or the publication of this paper.

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References

    1. May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419–427. - PubMed
    1. Virchow R. Uber die Erweinterung kleiner Gafassee. Arch Path Anat. 1851;3:427.
    1. O’Sullivan GJ, Semba CP, Bittner CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2000;11:823–836. - PubMed
    1. Thijs W, Rabe KF, Rosendaal FR, Middeldorp S. Predominance of left-sided deep vein thrombosis and body weight. J Thromb Haemost. 2010;8:2083–2084. - PubMed
    1. Peters M, Syed RK, Katz M, et al. May-Thurner syndrome: a not so uncommon cause of a common condition. Proc (Bayl Univ Med Cent). 2012;25:231–233. - PMC - PubMed