May-Thurner syndrome

What is it?

May-Thurner syndrome is a rare pathologic condition characterized by compression of the left iliac vein by the right iliac artery that causes symptoms and signs of altered venous flow in the lower extremities. This compression primarily affects the venous system of the left lower extremity, with increased venous pressure in the affected lower extremit. As venous flow decreases, the risk of deep vein thrombosis at the site of disease increases. Venous thrombosis occurs most often in patients who spend large periods of immobility, during pregnancy or immediately after childbirth, are immobilized, have severe dehydration, or clotting defects. May-Thurner syndrome can affect both sexes, with a slight predominance in thin women, and any age, peaking between 30 and 50 years of age.

Which are the symptoms?

Symptoms present are characterized by increased venous pressure in the lower extremities, such as edema, feeling of heaviness and pain in one leg, especially the left leg, recurrent deep vein thrombosis, especially in the left leg, and non-healing wounds, ulcer, dry and dark skin on the ankle.

  • Leg pain       
  • Swelling and burning in the legs       
  • Occurrence of ulcers       
  • Deep vein thrombosis       
  • Pelvic pain        

How is it diagnosed?

Diagnosis is based primarily on the patient's objective examination and medical history. With echocolordoppler imaging examinations, it is possible to make a diagnostic suspicion that subsequently requires second level investigations to assess the location of the venous return obstruction point and the presence of intravascular irregularities and compensatory hypertrophic collateral circulation.

Suggested exams

How is it treated?

In asymptomatic cases with mild symptoms, conservative approach with follow-up is recommended. In more severe symptoms, endovascular interventions have excellent results, including implantation of a self-expanding intravascular metallic stent in the stenotic tract of the left iliac vein.

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