May-Thurner Syndrome: Case Report and Review of the Literature Involving Modern Endovascular Therapy

Moudgill, Neil; Hager, Eric; Gonsalves, Carin F.; Larson, Robert A.; Lombardi, Joseph V.; DiMuzio, Paul

doi:10.2310/6670.2009.00027

Cited by 116 publications

(116 citation statements)

References 36 publications

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“…Interestingly, there is a left-sided predominance of proximal thrombosis during pregnancy that is thought to be due to an acquired compression of the left common iliac vein by the presence of the fetus (67). Similarly, individuals with May-Thurner syndrome suffer from compression of left common iliac vein that increases the risk of DVT (68).…”

Section: Reduced Blood Flow and Stasismentioning

confidence: 99%

New insights into the mechanisms of venous thrombosis

Mackman¹

2012

J. Clin. Invest.

364

249

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Section: Reduced Blood Flow and Stasismentioning

confidence: 99%

New insights into the mechanisms of venous thrombosis

Mackman¹

2012

J. Clin. Invest.

364

249

View full text Add to dashboard Cite

“…51 Other causes of IVC thrombosis include May-Thurner syndrome, which causes ilio-femoral thrombosis because of an intraluminal web or stenosis of the left common iliac vein, likely due to the direct mechanical impingement of the right common iliac artery on the left common iliac vein. 52 Although Budd-Chiari syndrome (primary hepatic vein thrombosis) is a hypertensive syndrome of the hepatic veins, it has features in common with IVC thrombosis owing to altered haemodynamics of the hepatic veins, IVC and portal vein. 53 …”

Section: Acquired Ivc Thrombosismentioning

confidence: 99%

Inferior vena cava thrombosis: A review of current practice

et al. 2013

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Inferior vena cava (IVC) thrombosis remains under-recognised as it is often not pursued as a primary diagnosis. The aetiology of IVC thrombosis can be divided into congenital versus acquired, with all aetiological factors found among Virchow's triad of stasis, injury and hypercoagulability. Signs and symptoms are related to aetiology and range from no symptoms to cardiovascular collapse. Painful lower limb swelling combined with lower back pain, pyrexia, dilatation of cutaneous abdominal wall veins and a concurrent rise in inflammatory markers are suggestive of IVC thrombosis. Following initial lower limb venous duplex, magnetic resonance imaging (MRI) is the optimal non-invasive imaging tool. Aetiology directs treatment, which ranges from anticoagulation and lower limb compression to open surgery, with endovascular therapies increasingly favoured. The objective of this review is to assess current literature on the aetiology, presentation, investigation, treatment, prognosis and other factors pertaining to IVC thrombosis.

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“…5,16 In the case of a DVT associated with MTS, systemic anticoagulation alone is not adequate, as it fails to address the underlying anatomical compression. 24,25 It is suggested that the anatomical defect should be repaired with the use of stents and balloon venoplasty. 11 Patients with a high clot burden should also undergo inferior vena cava filter placement.…”

Section: Managementmentioning

confidence: 99%

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

Marchand

Boucher

O’Shaughnessy

2015

Journal of Chiropractic Medicine

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Objective: The purpose of this case report is to describe a patient who presented with acute musculoskeletal symptoms but was later diagnosed with multiple deep vein thrombosis (DVT). Clinical Features: An 18-year-old female presented to a chiropractic clinic with left lumbosacral pain with referral into the posterior left thigh. A provisional diagnosis was made of acute myofascial syndrome of the left piriformis and gluteus medius muscles. The patient received 3 chiropractic treatments over 1 week resulting in 80% improvement in pain intensity. Two days later, a sudden onset of severe abdominal pain caused the patient to seek urgent medical attention. A diagnostic ultrasound of the abdomen and pelvis were performed and interpreted as normal. Following this, the patient reported increased pain in her left leg. Evaluation revealed edema of the left calf and decreased left lower limb sensation. A venous Doppler ultrasound was ordered. Intervention and Outcomes: Doppler ultrasound revealed reduction of the venous flow in the femoral vein area. An additional ultrasonography evaluation revealed an extensive DVTs affecting the left femoral vein and iliac axis extending towards the vena cava. Upon follow-up with a hematologist, the potential diagnosis of May-Thurner syndrome was considered based on the absence of blood dyscrasias and sustained anatomical changes found in the left common iliac vein at its junction with the right common iliac artery. A week following discharge, she presented with chest pain and was diagnosed with venous thromboembolism. The patient was successfully treated with anticoagulation therapy and insertion of a vena cava filter. Conclusion: Although DVTs are common in the general population, presence in low-risk individuals may be overlooked. In the presence of subtle initial clinical signs such as those described in this case report, clinicians should keep a high index of suspicion for a DVT.Rapid identification of such clinical signs in association with a lack of objective examination findings warrants further evaluation due to potentially negative outcomes.

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May-Thurner Syndrome: Case Report and Review of the Literature Involving Modern Endovascular Therapy

Cited by 116 publications

References 36 publications

New insights into the mechanisms of venous thrombosis

New insights into the mechanisms of venous thrombosis

Inferior vena cava thrombosis: A review of current practice

Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

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