Iatrogenic May–Thurner Syndrome After EVAR

Pandit, Amrita S.; Hayes, Maura; Guiney-Borgelt, Sheila; Dietzek, Alan M.

doi:10.1016/j.avsg.2013.07.019

Cited by 17 publications

(13 citation statements)

References 17 publications

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“…Endovascular therapy has become the mainstay of treatment for MTS and involves catheter-directed-thrombolysis and angioplasty, followed by stent insertion. 3,7,[14][15][16] In this case, our patient had a duplex ultrasound study that demonstrated nonocclusive thrombus in the left external iliac vein. In hindsight, this finding could have alerted us to prophylactically anticoagulate the patient with LMWH in the immediate postarterial interventional period until the patient was able to completely mobilize.…”

Section: Discussionmentioning

confidence: 75%

“…Symptom onset may occur days to years after surgery and either CIV may be compressed. [16][17][18][19][20] Our case highlighted the importance of being cognizant to this rare but potentially devastating complication that can present days following the index procedure. This case illustrates the successful multidisciplinary team approach between vascular surgeons, vascular interventional radiologists, and hematologists, drawing experiences from different specialties to attain a positive outcome.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Cause of May-Thurner Syndrome Postarterial Intervention

Chan

Choke

Tang

et al. 2019

J Clin Interv Radiol ISVIR

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May-Thurner syndrome (MTS) is rare condition thought to occur due to an anatomical variation. In MTS, there is left iliac vein compression by the right iliac artery and lumbar spine resulting in left lower limb deep venous thrombosis. The authors report a rare cause of MTS postarterial intervention. They describe the unusual case of an Asian man who presented with acute left lower limb deep venous thrombosis 5 days following left common iliac artery angioplasty and stent insertion. Computed tomographic (CT) venogram demonstrated the left iliac vein compression by the left iliac artery stent. Successful recanalization of the thrombosed iliac vein was achieved with a combination of pulse spray thrombolysis and rheolytic mechanical thrombectomy, followed by angioplasty and stent placement in the iliac vein. There was rapid and complete resolution of symptoms. This report illustrates the use of complementary imaging modalities and a multidisciplinary team approach to achieve a successful technical and clinical outcome following an unusual case of MTS postarterial intervention and the subsequent successful endovascular management.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

A Rare Cause of May-Thurner Syndrome Postarterial Intervention

Chan

Choke

Tang

et al. 2019

J Clin Interv Radiol ISVIR

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“…MTS often goes undiagnosed and may only become symptomatic when there is trauma, or a significant surgery such as knee or hip replacement is involved. There are several rare presentations which can occur such as acquired MTS after endovascular stent/graft procedures [ 5 - 6 ]. MTS may present secondary to urinary bladder distention [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

May-Thurner Syndrome Variant Identified in a Cadaver: First Reported Case

Simonds

Patel

Vetter

et al. 2018

Cureus

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May–Thurner syndrome (MTS) is defined as the compression of the left common iliac vein by the right common iliac artery. Herein, we describe an unusual case of a male cadaver with right-sided compression of the inferior vena cava and the left and right common iliac veins by the right common iliac artery. This is an unusual variant of this syndrome and the first known case report. We suggest this variant be termed MTS type II due to the additional compression of the inferior vena cava.

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“…[12][13][14] There is an iatrogenic case of MTS reported secondary to placement of an aortic stent graft. 15 Fretz and Binkert reported a variant MTS with compression of the IVC by right common iliac artery in a patient with high aortic bifurcation. 16…”

Section: Clinical Presentationmentioning

confidence: 99%

Evolving Concepts in the Diagnosis and Management of May–Thurner Syndrome

Chamarthy

Sutphin

Anderson

et al. 2017

J Clin Interv Radiol ISVIR

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May–Thurner syndrome is a common cause of left lower extremity venous thrombosis resulting from repetitive and dynamic compression of the left common iliac vein by the right common iliac artery, commonly seen in young to middle-aged women. The diagnosis requires high clinical suspicion. Computed tomography venography and magnetic resonance venography depict the extent of venous thrombosis and iliac venous compression in patients with underlying thrombotic and nonthrombotic pathologies, respectively. Contrast venography allows detection of acute and chronic thrombus, associated venous obstruction, and collaterals but is of limited value to evaluate the early venous wall abnormalities. Endovascular ultrasound is highly useful to detect early mural changes and accurately quantify venous narrowing. Endovascular intervention with balloon dilatation and stenting with or without pharmacomechanical thrombectomy followed by long-term anticoagulation is the preferred treatment with excellent technical and clinical outcomes. This review focuses on the current understanding of the pathology, clinical presentation, and endovascular management of May–Thurner syndrome.

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Iatrogenic May–Thurner Syndrome After EVAR

Cited by 17 publications

References 17 publications

A Rare Cause of May-Thurner Syndrome Postarterial Intervention

A Rare Cause of May-Thurner Syndrome Postarterial Intervention

May-Thurner Syndrome Variant Identified in a Cadaver: First Reported Case

Evolving Concepts in the Diagnosis and Management of May–Thurner Syndrome

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