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May-Thurner Syndrome

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Endovascular Interventions

Abstract

May-Thurner syndrome (MTS) is an anatomic variable condition of venous outflow obstruction, secondary to extrinsic compression. Although this syndrome is rare, its prevalence is likely underestimated. The pathology of this condition is secondary to a partial obstruction of the vein by an overlying artery with subsequent entrapment of the left common iliac vein. Regardless of the mechanism, this causes partial or complete impedance to the iliac vein outflow with subsequent possible obstruction and extensive ipsilateral deep vein thrombosis (DVT) of the ipsilateral extremity. Clinical presentations include, but are not limited to, pain, swelling, venous stasis ulcers, and skin discolorations. With extensive DVT, postphlebitic syndrome – with all of its sequelae – may develop as well. Treatment is based on the clinical presentation. In cases of extensive DVT with MTS, therapy includes staged thrombolysis with prophylactic retrievable inferior vena cava (IVC) filter placement, followed by angioplasty/stenting of the left iliac vein.

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References

  1. Hassell DR, Reifsteck JE, Harshfield DL, et al. Unilateral left leg edema: a variation of the May-Thurner syndrome. Cardiovasc Intervent Radiol. 1987;10:89–91.

    Article  PubMed  CAS  Google Scholar 

  2. Steinberg JB, Jacocks MA. May-Thurner syndrome: a previously unreported variant. Ann Vasc Surg. 1993;7:577–81.

    Article  PubMed  CAS  Google Scholar 

  3. Burke RM, Rayan SS, Kasirajan K, et al. Unusual case of right-sided May-Thurner syndrome and review of its management. Vascular. 2006;14:47–50.

    Article  PubMed  Google Scholar 

  4. Abboud G, Midulla M, Lions C, et al. Right-sided. May-Thurner syndrome. Cardiovasc Intervent Radiol. 2010;33:1056–9.

    Article  PubMed  Google Scholar 

  5. Oteros Fernandez R, Bravo Rodriguez F, Delgado Acosta F, et al. May-Thurner syndrome and surgery for scoliosis. Radiologia. 2008;50:245–7.

    Article  PubMed  CAS  Google Scholar 

  6. Dogan OF, Boke E. Three cases with May-Thurner syndrome: a possibly under-reported disorder. Vasa. 2005;34:147–51.

    Article  PubMed  CAS  Google Scholar 

  7. Murphy EH, Davis CM, Journeycake JM, et al. Symptomatic iliofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner syndrome. J Vasc Surgery. 2009;49:697–703.

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  9. Kim YH, Ko SM, Kim HT. Spontaneous rupture of the left common iliac vein associated with May Thurner syndrome: successful management with surgery and placement of an endovascular stent. Br J Radiol. 2007;80:e176–9.

    Article  PubMed  CAS  Google Scholar 

  10. Kiernan TJ, Yan BP, Cubeddu RJ, et al. May-Thurner syndrome in patients with cryptogenic stroke and patent foramen ovale: an important clinical association. Stroke. 2009;40:1502–4.

    Article  PubMed  Google Scholar 

  11. Greer DM, Buonanno FS. Cerebral infarction in conjunction with patent foramen ovale and May-Thurner syndrome. J Neuroimag. 2001;11:432–4.

    Article  CAS  Google Scholar 

  12. Suwanabol PA, Tefera G, Schwarze ML. Syndromes associated with the deep veins: phlegmasia cerulea dolens, May-Thurner syndrome, and nutcracker syndrome. Perspect Vasc Surg Endovasc Ther. 2010;22:223–30.

    Article  PubMed  Google Scholar 

  13. Wolpert LM, Rahmani O, Stein B, et al. Magnetic resonance venography in the diagnosis and management of May-Thurner syndrome. Vasc Endovascular Surg. 2002;36:51–7.

    Article  PubMed  Google Scholar 

  14. Oguzkurt L, Tercan F, Pourbagher MA, et al. Computed tomography findings in 10 cases of iliac vein compression (May-Thurner) syndrome. Eur J Radiol. 2005;55:421–5.

    Article  PubMed  Google Scholar 

  15. Ferris EJ, Lim WN, Smith PL, et al. May-Thurner syndrome. Radiology. 1983;147:29–31.

    PubMed  CAS  Google Scholar 

  16. Ahmed HK, Hagspiel KD. Intravascular ultrasonographic findings in May-Thurner syndrome (iliac vein compression syndrome). J Ultrasound Med. 2001;20:251–6.

    PubMed  CAS  Google Scholar 

  17. 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;21:22–6.

    Article  PubMed  CAS  Google Scholar 

  18. Heniford BT, Senler SO, Olsofka JM, et al. May-Thurner syndrome: management by endovascular surgical techniques. Ann Vasc Surg. 1998;12:482–6.

    Article  PubMed  CAS  Google Scholar 

  19. O’Sullivan GJ, Semba CP, Bittner CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Int Radiol. 2000;11:823–36.

    Article  Google Scholar 

  20. Patel NH, Stookey KR, Ketcham DB, et al. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome. J Vasc Int Radiol. 2000;11:1297–302.

    Article  CAS  Google Scholar 

  21. Heijmen RH, Bollen TL, Duyndam DA, et al. Endovascular venous stenting in May-Thurner syndrome. J Cardiovasc Surg. 2001;42:83–7.

    CAS  Google Scholar 

  22. Lamont JP, Pearl GJ, Patetsios P, et al. Prospective evaluation of endoluminal venous stents in the treatment of the May-Thurner syndrome. Ann Vasc Surg. 2002;16:61–4.

    Article  PubMed  Google Scholar 

  23. Kim JY, Choi D, Guk Ko Y, et al. Percutaneous treatment of deep vein thrombosis in May-Thurner syndrome. Cardiovasc Intervent Radiol. 2006;29:571–5.

    Article  PubMed  Google Scholar 

  24. Palma EC, Esperon R. Vein transplants and grafts in the surgical treatment of the postphlebitic syndrome. J Cardiovasc Surg. 1960;1:94–107.

    CAS  Google Scholar 

  25. Dale WA, Harris J. Cross-over vein grafts for iliac and femoral venous occlusion. J Cardiovasc Surg. 1969;10:458–62.

    CAS  Google Scholar 

  26. Dale WA. Crossover vein grafts for relief of iliofemoral venous block. Surgery. 1965;57:608–12.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, 3110 MacCorkle Ave., SE, Charleston, WV, 25304, USA

    Albeir Y. Mousa MD

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  1. Albeir Y. Mousa MD
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Editor information

Editors and Affiliations

  1. Edward Hines, Jr. VA Hospital Loyola University Medical Center, Glen Ellyn, Illinois, USA

    Robert S. Dieter

  2. Northern Illinois Surgery Center, Naperville, Illinois, USA

    Raymond A. Dieter, Jr.

  3. University of Tennessee Medical Center, Knoxville, Tennessee, USA

    Raymond A. Dieter, III

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Mousa, A.Y. (2014). May-Thurner Syndrome. In: Dieter, R., Dieter, Jr., R., Dieter, III, R. (eds) Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7312-1_90

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  • DOI: https://doi.org/10.1007/978-1-4614-7312-1_90

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7311-4

  • Online ISBN: 978-1-4614-7312-1

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