Endovascular treatment of iliac vein compression syndrome (May–Thurner)

Budnur, Srinivas Chikkaswamy; Singh, Bhupinder; Mahadevappa, Nagesh C.; Reddy, Babu; Nanjappa, Manjunath Cholenahally

doi:10.1007/s12928-012-0122-3

Cited by 18 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…24,41,65 However, venography is typically not performed unless thrombolysis is anticipated, owing to its invasive nature and postprocedural complications (eg, phlebitis). 66 Besides venography, other imaging techniques, such as multidetector computed tomography (CT) scans, 15,41,[67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83] magnetic resonance venography (MRV), 23,60,[84][85][86][87] and intravascular ultrasonography, 16,[88][89][90][91][92][93] have been used to image iliac venous compression and are described in Table 2.…”

Section: Iag Nos Is Of May-th Urner Syndromementioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

102

100

View full text Add to dashboard Cite

Patients with May‐Thurner syndrome (MTS) are at elevated risk of developing an extensive left iliofemoral deep vein thrombosis (DVT; localized blood clot) due to an anatomical variant where the right common iliac artery compresses the left common iliac vein against the lumbar spine. While MTS was initially presumed to be rare when it was first anatomically defined in 1957, case reports of this syndrome have recently become more frequent, perhaps due to improved imaging techniques allowing for enhanced visualization of the iliac veins. Still, the population burden of this condition is unknown, and there is speculation it may be higher than generally perceived. In the present review, we (a) review history of how MTS became recognized, (b) describe practical challenges of studying MTS in population‐based settings due to the specialized imaging required for diagnosis, (c) discuss why the contribution of MTS to DVT may be underestimated, (d) describe uncertainty regarding the degree of venous compression which leads to DVT, and (e) outline future research needs. Our goal is to raise awareness of MTS and spark additional research into the epidemiology of this condition, which may be an underappreciated causative venous thromboembolism risk factor.

show abstract

Section: Iag Nos Is Of May-th Urner Syndromementioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

102

100

View full text Add to dashboard Cite

show abstract

“…Вместе с тем всегда следует учитывать такой этиологический фактор СТВП, как синдром Мея-Тернера, адекватная коррекция которого обеспечивает успех лечебного процесса и безрецидивное течение послеоперационного периода [3,8]. В настоящее время доказано, что эндоваскулярное стентирование -наиболее эффективный способ восстановления проходимости подвздошных вен при синдроме Мея-Тернера [15][16][17]. В случае сочетания СТВП и компрессии левой общей подвздошной вены предпочтительнее первым этапом выполнить эндоваскулярное стентирование, затем -вмешательство на гонадных венах [3].…”

Section: Discussionunclassified

The Potential of Hybrid Technologies for the Treatment of the Pelvic Congestion Syndrome

Sg¹,

Сажин²,

Maslennikov³

et al. 2018

Flebol.

View full text Add to dashboard Cite

Возможности гибридных технологий в лечении синдрома тазового венозного полнокровия Д.м.н., проф. С.Г. ГАВРИЛОВ 1 *, д.м.н., член-корр. РАН А.В. САЖИН 1 , к.м.н. М.А. МАСЛЕННИКОВ 2 , к.м.н. И.С. ЛЕБЕДЕВ 2 , к.м.н. Е.П. МОСКАЛЕНКО 2 , К.В. КИРСАНОВ 2 , А.Г. ЮСУФОВ 3 1 Кафедра факультетской хирургии №1 лечебного факультета Российского национального исследовательского медицинского университета им. Н.И. Пирогова, Москва, Россия; 2 Городская клиническая больница №1 им. Н.И. Пирогова, Москва, Россия; 3 кафедра урологии и андрологии лечебного факультета Российского национального исследовательского медицинского университета им. Н.И. Пирогова, Москва, Россия Цель исследования-демонстрация возможностей эндоваскулярных и эндоскопических методик в лечении тазового венозного полнокровия, обусловленного синдромом Мея-Тернера в сочетании с синдромом правой гонадной вены. Материал и методы. Пациентка, 37 лет, с клиническими признаками тазового венозного полнокровия (ТВП). По результатам компьютерной томографии, оварикографии и тазовой флебографии подтвержден диагноз синдрома тазового венозного полнокровия (СТВП) и диагностированы синдромы Мея-Тернера и правой овариальной вены. Компрессия правого мочеточника гонадной веной сопровождалась явлениями правосторонней уретерообструкции. Результаты. Первым этапом лечения выполнено эндоваскулярное стентирование левых подвздошных вен, вторымретроперитонеальная эндоскопическая резекция правой гонадной вены, затем-эндоскопическое стентирование правого мочеточника. Комплекс проведенных лечебных мероприятий позволил восстановить проходимость левой общей подвздошной вены, купировать симптомы ТВП и правосторонней уретерообструкции. Проведен анализ медицинской литературы, посвященной проблеме лечения синдромов Мея-Тернера, тазового венозного полнокровия и правой овариальной вены. Заключение. СТВП может сочетаться со стенозом левой общей подвздошной вены и синдромом правой гонадной вены. Адекватная диагностика состояния тазовых вен, мочевыделительной системы и комбинированное поэтапное применение эндоваскулярных методик позволяют эффективно купировать признаки ТВП, нормализовать пассаж мочи по мочеточникам. Ключевые слова: синдром тазового венозного полнокровия, синдром Мея-Тернера, синдром правой гонадной вены, эндоваскулярное стентирование подвздошных вен, ретроперитонеальная эндоскопическая резекция гонадных вен, стентирование мочеточника.

show abstract

“…18,22,23 Simple catheter-directed intravenous thrombolysis usually could not recanalize the iliac vein or prevent the recanalized vein from relapsing. Complex treatments were recommented.…”

Section: Discussionmentioning

confidence: 99%

Underlying Anatomy and Typing Diagnosis of May-Thurner Syndrome and Clinical Significance

Ouyang

2016

Spine

View full text Add to dashboard Cite

Study Design.Cross-sectional study.Objective.To explore the underlying anatomy of May-Thurner syndrome (MTS) using computed tomography (CT) and discuss its clinical significance for typing diagnosis.Summary of Background Data.Because the anatomical position of the corpse cannot fully illustrate the actual clinical situation in vivo, the diversity of MTS has not been fully elucidated yet.Methods.We retrospectively analyzed the data of 69 patients with MTS. By CT showing, patients were categorized to simple MTS (sMTS, 22 patients), lumbar degeneration-related MTS (dMTS, 33 patients) and other causes MTS (oMTS, 14 patients); meanwhile, a healthy control group were set. Evaluated indexes were onset age, course of disease, diameter of the iliac vein tunnel (IVTD), lumbar degeneration-related iliac vein compression (IVC), therapeutic effect, and diagnostic cutoff of risk IVTD prone to MTS.Results.The onset age of sMTS, dMTS, and oMTS were respectively 42.3 ± 6.5 years, 61.5 ± 10.6 years, and 53.1 ± 16.8 years (P < 0.001); courses were respectively 12.1 ± 9.2 days, 22.5 ± 7.6 days, and 6.8 ± 6.7 days (P = 0.002). IVTDs of sMTS, dMTS, oMTS, and the control were respectively 2.52 ± 0.50 mm, 2.29 ± 0.30 mm, 5.93 ± 2.21 mm, and 4.34 ± 1.61 mm (P < 0.001). Lumbar degeneration-related IVC in dMTS occurred at 41 places, including forward bulging or protruding intervertebral discs (51%,17/33), osteophytes (50%,16/33), and spondylolisthesis (19%, 8/33), but none happened in sMTS, oMTS, and the control. Eighty-six percent of sMTSs, 55% dMTSs, and none oMTSs needed intravenous stent-implanted operation to obtain effective treatment. MTS type (Waldχ2 = 6.092, P = 0.009), course (Waldχ2 = 4.618, P = 0.032), and treatment plan (Waldχ2 = 14.748, P < 0.001) markedly influence the therapeutic result. The cutoff of risk IVTD for sMTS and dMTS was 2.98 mm, which diagnostic sensitivity was 90% and specificity 100%.Conclusion.Owing to the distinct pathoanatomy and causes, diagnosis in classification of MTS by CT is helpful in accurate treatment program.Level of Evidence: 3

show abstract

Endovascular treatment of iliac vein compression syndrome (May–Thurner)

Cited by 18 publications

References 17 publications

May‐Thurner syndrome: History of understanding and need for defining population prevalence

May‐Thurner syndrome: History of understanding and need for defining population prevalence

The Potential of Hybrid Technologies for the Treatment of the Pelvic Congestion Syndrome

Underlying Anatomy and Typing Diagnosis of May-Thurner Syndrome and Clinical Significance

Contact Info

Product

Resources

About