Mousa AY, AbuRahma AF, et al.
Annals of vascular surgery. Date of publication 2013 Oct 1;volume 27(7):984-95.
1. Ann Vasc Surg. 2013 Oct;27(7):984-95. doi: 10.1016/j.avsg.2013.05.001. Epub 2013
Jul 10.
May-Thurner syndrome: update and review.
Mousa AY(1), AbuRahma AF.
Author information:
(1)Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia
University, Charleston, WV 25304, USA. amousa@hsc.wvu.edu
May-Thurner syndrome (MTS) is an anatomically variable condition of venous
outflow obstruction caused by 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 common iliac vein by an overlying
common iliac 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
discoloration. With extensive DVT, postphlebetic syndrome, with all of its
sequelae, may also develop. Treatment is based on the clinical presentation and
includes staged thrombolysis with/without prophylactic retrievable inferior vena
cava filter placement, followed by angioplasty/stenting of the left iliac vein in
MTS patients with extensive DVT. This review highlights the variable
presentations of MTS and outlines possible management within the current Society
for Vascular Surgery consensus.
Copyright © 2013 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.avsg.2013.05.001
PMID: 23850314 [Indexed for MEDLINE]
