Skip to main content

May-Thurner Syndrome

  • Chapter
  • First Online:
Venous Disorders
  • 725 Accesses

Abstract

May-Thurner syndrome (MTS) is a rarely diagnosed condition in which there is extrinsic venous compression by the arterial system against bony structure in the iliocaval territory. The condition is mostly asymptomatic in cases where there is partial obstruction, but progression with symptoms related to chronic venous hypertension or venous occlusion can occur, with or without venous thrombosis. This condition should always be kept in mind if a young woman comes with lower extremity swelling or deep vein thrombosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Virchow R. Ueber die Erweiterung kleinerer Gefäfse. Arch Pathol Anat Physiol Klin Med. 1851;3:427.

    Article  Google Scholar 

  2. Shebel ND, Whalen CC. Diagnosis and management of iliac vein compression syndrome. J Vasc Nurs. 2005;23:10–7.; quiz 18–19. https://doi.org/10.1016/j.jvn.2004.12.001.

    Article  PubMed  Google Scholar 

  3. Brazeau NF, Harvey HB, Pinto EG, Deipolyi A, Hesketh RL, Oklu R. May-Thurner syndrome: diagnosis and management. Vasa. 2013;42:96–105. https://doi.org/10.1024/0301-1526/a000252.

    Article  PubMed  Google Scholar 

  4. Burke RM, Rayan SS, Kasirajan K, et al. Unusual case of right-sided May-Thurner syndrome and review of its management. Vascular. 2006;14:47.

    Article  Google Scholar 

  5. Moudgill N, Hager E, Gonsalves C, et al. May-Thurner syndrome: case report and review of the literature involving modern endovascular therapy. Vascular. 2009;17:330.

    Article  Google Scholar 

  6. May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419.

    Article  CAS  Google Scholar 

  7. Marston W, Fish D, Unger J, Keagy B. Incidence of and risk factors for iliocaval venous obstruction in patients with active or healed venous leg ulcers. J Vasc Surg. 2011;53:1303.

    Article  Google Scholar 

  8. Hurst DR, Forauer AR, Bloom JR, Greenfield LJ, Wakefield TW, Williams DM. Diagnosis and endovascular treatment of iliocaval compression syndrome. J Vasc Surg. 2001;34:106–13. https://doi.org/10.1067/mva.2001.114213.

    Article  CAS  PubMed  Google Scholar 

  9. Ibrahim W, Al Safran Z, Hasan H, Zeid WA. Endovascular management of May-Thurner syndrome. Ann Vasc Dis. 2012;5:217–21. https://doi.org/10.3400/avd.cr.12.00007.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Patel NH, Stookey KR, Ketcham DB, Cragg AH. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome. J Vasc Interv Radiol. 2000;11:1297–302. https://doi.org/10.1016/S1051-0443(07)61304-9.

    Article  CAS  PubMed  Google Scholar 

  11. Wolpert LM, Rahmani O, Stein B, Gallagher JJ, Drezner AD. Magnetic resonance venography in the diagnosis and management of May-Thurner syndrome. Vasc Endovasc Surg. 2002;36:51–7. https://doi.org/10.1177/153857440203600109.

    Article  Google Scholar 

  12. Kibbe MR, Ujiki M, Goodwin AL, Eskandari M, Yao J, Matsumura J. Iliac vein compression in an asymptomatic patient population. J Vasc Surg. 2004;39:937–43. https://doi.org/10.1016/j.jvs.2003.12.032.

    Article  PubMed  Google Scholar 

  13. McDermott S, Oliveira G, Ergül E, Brazeau N, Wicky S, Oklu R. May-Thurner syndrome: can it be diagnosed by a single MR venography study? Diagn Interv Radiol. 2013;19:44–8. https://doi.org/10.4261/1305-3825.DIR.5939-12.1.

    Article  PubMed  Google Scholar 

  14. Liu Z, Gao N, Shen L, Yang J, Zhu Y, Li Z, Si Y. Endovascular treatment for symptomatic iliac vein compression syndrome: a prospective consecutive series of 48 patients. Ann Vasc Surg. 2014;28:695–704. https://doi.org/10.1016/j.avsg.2013.05.019.

    Article  PubMed  Google Scholar 

  15. Lensing AW, Prandoni P, Brandjes D, et al. Detection of deep-vein thrombosis by real-time B-mode ultrasonography. N Engl J Med. 1989;320:342.

    Article  CAS  Google Scholar 

  16. Labropoulos N, Borge M, Pierce K, Pappas PJ. Criteria for defining significant central vein stenosis with duplex ultrasound. J Vasc Surg. 2007;46:101.

    Article  Google Scholar 

  17. Lamba R, Tanner DT, Sekhon S, McGahan JP, Corwin MT, Lall CG. Multidetector CT of vascular compression syndromes in the abdomen and pelvis. Radiographics. 2014;34:93–115. https://doi.org/10.1148/rg.341125010.

    Article  PubMed  Google Scholar 

  18. Chung JW, Yoon CJ, Jung SI, Kim HC, Lee W, Kim YI, Jae HJ, Park JH. Acute iliofemoral deep vein thrombosis: evaluation of underlying anatomic abnormalities by spiral CT venography. J Vasc Interv Radiol. 2004;15:249–56. https://doi.org/10.1097/01.RVI.0000109402.52762.8D.

    Article  PubMed  Google Scholar 

  19. Oguzkurt L, Tercan F, Pourbagher MA, Kizilkilic O, Turkoz R, Boyvat F. Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome. Eur J Radiol. 2005;55:421–5. https://doi.org/10.1016/j.ejrad.2004.11.002.

    Article  PubMed  Google Scholar 

  20. Gurel K, Gurel S, Karavas E, Buharalıoglu Y, Daglar B. Direct contrast-enhanced MR venography in the diagnosis of May-Thurner syndrome. Eur J Radiol. 2011;80:533–6. https://doi.org/10.1016/j.ejrad.2010.04.033.

    Article  PubMed  Google Scholar 

  21. Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2012;55:1449.

    Article  Google Scholar 

  22. Birn J, Vedantham S. May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med. 2015;20:74.

    Article  Google Scholar 

  23. DeRubertis BG, Lew W, Jabori S, et al. Importance of intravascular ultrasound imaging during percutaneous treatment of May-Thurner syndrome. J Vasc Surg. 2012;56:580.

    Article  Google Scholar 

  24. Mickley V, Schwagierek R, Rilinger N, et al. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg. 1998;28:492.

    Article  CAS  Google Scholar 

  25. Gloviczki P, Lawrence PF. Iliac vein stenting and contralateral deep vein thrombosis. J Vasc Surg Venous Lymphat Disord. 2017;5:5.

    Article  Google Scholar 

  26. Jaff MR, McMurtry MS, Archer SL, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011;123:1788.

    Article  Google Scholar 

  27. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e419S.

    Article  CAS  Google Scholar 

  28. Hartung O, Benmiloud F, Barthelemy P, et al. Late results of surgical venous thrombectomy with iliocaval stenting. J Vasc Surg. 2008;47:381.

    Article  Google Scholar 

  29. Palma EC, Esperon R. Vein transplants and grafts in the surgical treatment of the postphlebitic syndrome. J Cardiovasc Surg (Torino). 1960;1:94.

    CAS  Google Scholar 

  30. Dale WA, Harris J. Cross-over vein grafts for iliac and femoral venous occlusion. J Cardiovasc Surg (Torino). 1969;10:458.

    CAS  Google Scholar 

  31. Binkert CA, Schoch E, Stuckmann G, et al. Treatment of pelvic venous spur (May-Thurner syndrome) with self-expanding metallic endoprostheses. Cardiovasc Intervent Radiol. 1998;21:22.

    Article  CAS  Google Scholar 

  32. 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Khanna, S., Khanna, A.K. (2018). May-Thurner Syndrome. In: Khanna, A., Jindal, R. (eds) Venous Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-13-1108-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-1108-6_17

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-1107-9

  • Online ISBN: 978-981-13-1108-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics