May-Thurner Syndrome

Sedhai, Yub Raj; Golamari, Reshma; Salei, Aliaksei; Alukal, Joseph; Basnyat, Soney; Pathak, Sunil; Timalsina, Santosh; Zia, Subtain; Malhan, Suraj; Bhatacharya, Priyanka T.

doi:10.1016/j.amjms.2017.09.011

Cited by 19 publications

(12 citation statements)

References 15 publications

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“…We report an interesting case of MTS presenting as bilateral PE and left-sided DVT. Although cases of DVT have been frequently associated with this syndrome in the past, only a few cases have presented with acute bilateral pulmonary emboli 4–6…”

Section: Discussionmentioning

confidence: 99%

“…This seems to validate the fact that an associated MTS is likely an underdiagnosed clinical entity and therefore should be considered in recurrent or unprovoked DVT. Although rare, small retrospective studies have shown a possible association of MTS with pregnancy and obesity, probably due to alteration in the anatomic alignment of blood vessels due to increased soft tissue deposition 5 10 11. Doppler ultrasound can detect characteristics of proximal obstruction even if extremity venous study may be normal, for example, a loss of collapsibility of common femoral vein, lack of respiratory variations and an absence of response to Valsalva manoeuvre 5…”

Section: Discussionmentioning

confidence: 99%

“…Continuing thrombolytic infusion for an additional 24–48 hours has also been suggested for the prevention of clot embolism 12 16. One case series mentions the use of catheter guided thrombolysis with tissue plasminogen activator, mechanical thrombectomy, IVC filter placement, the use of intravascular stent deployment with or without balloon venoplasty 5. Endovascular therapy is directed to restore inline patency to the left deep venous system using catheter-directed thrombolytic treatment and treatment of the compression with a stent or angioplasty alone.…”

Section: Discussionmentioning

confidence: 99%

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Acute bilateral pulmonary embolism in a 21-year-old: is May-Thurner syndrome in our differential?

Bhadra¹,

Somasundaram

Iltchev

et al. 2019

BMJ Case Rep

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May-Thurner syndrome (MTS) is a clinical condition where the left common iliac vein gets compressed by the overlying right common iliac artery anterior to the fifth lumbar vertebra and the sacral promontory. It results in vessel wall injury and predisposition to thrombosis. We present a case of a 21-year-old African-American man with no significant past medical history who came to the emergency department with left lower limb swelling associated with shortness of breath, and was eventually diagnosed to have extensive left lower extremity deep vein thrombosis (DVT) along with acute bilateral extensive pulmonary embolism (PE) as a consequence to MTS. MTS should be considered in the differential when young patients present with unprovoked or recurrent left-sided DVT. Diagnosis of this anatomical variant is critical as it may need long-term anticoagulation and consideration of pharmaco-mechanical intervention such as mechanical thrombectomy and venoplasty with or without stenting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute bilateral pulmonary embolism in a 21-year-old: is May-Thurner syndrome in our differential?

Bhadra¹,

Somasundaram

Iltchev

et al. 2019

BMJ Case Rep

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“…Kim et al further categorised the clinical stages of progressive iliac vein compression, from asymptomatic stage I to stage 3 when patients presented with a left iliac DVT 6. In fact, a DVT or even a pulmonary embolus (PE) is sometimes the first symptom reported, often by female patients in their second to fourth decade of life, triggered by an episode of prolonged immobilisation or pregnancy 7 8. This association between lower limb DVT and MTS is increasingly being recognised, with suggestions that MTS is being underdiagnosed because further workup is usually stopped after the confirmation of the diagnosis of DVT 7…”

Section: Discussionmentioning

confidence: 99%

Recurrent unilateral cellulitis: is it May-Thurner syndrome (MTS)?

Choy¹,

Bhutia

2019

BMJ Case Rep

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May-Thurner syndrome (MTS) is a differential diagnosis to be considered in a patient with recurrent unilateral cellulitis. A 73-year-old woman initially presented with recurrent unilateral cellulitis of her left lower limb. A CT scan demonstrated a stenosed left common iliac vein (CIV) narrowed at its origin by the proximal right common iliac artery consistent with MTS. The chronicity of the condition at the time of diagnosis made attempts to recanalise the CIV unsuccessful. A diagnosis of MTS should be considered in a patient with chronic unilateral limb oedema/cellulitis as it represents a potentially treatable condition if detected early.

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“…The presence of hypercoagulable states in the setting of endovenous stents is associated with higher rates of secondary loss of stent patency and stent thrombosis. This is observed in few anecdotal case reports 6 suggesting that this is an area that would benefit from further research.…”

mentioning

confidence: 85%