May-Thurner Syndrome Resulting in Acute Iliofemoral Deep Vein Thrombosis in the Postpartum Period

Abstract

May-Thurner syndrome can predispose postpartum patients to large, proximal thrombi and may be treated effectively with a combination of thrombolysis and stent placement. May-Thurner Syndrome should be considered in the differential diagnosis of pelvic thrombosis, especially when thrombophilias are excluded.

Incidence and clinical significance of iliac vein compression

“…6 Of the patients presenting with acute DVT or chronic venous stasis of the left leg, 18-40% can potentially have IVCS. 7 CIV compression may not be as uncommon as previously thought. 8 It has been described as three different clinical stages by Kim et al 9 based on the presence of asymptomatic compression, spur formation within the CIV and presence of thrombosis.…”

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

“…6,7 Patients that develop a left-sided DVT in the context of MTS are typically young adults that exhibit sudden swelling of the left lower extremity following surgery, during immobilization, or during pregnancy and/or the postpartum period. 3,6,[8][9][10][11][12] The occurrence of MTS in adolescents has also been documented in various case reports. [13][14][15][16][17][18][19][20][21] While MTS does occur among men, it is more common in females though the reason for this has not yet been completely explained.…”

“…Clinical phases of MTS include a prolonged asymptomatic period of left iliac vein compression followed by the gradual development of an intraluminal venous fibrous band (ie, spur), which can subsequently progress to an acute unilateral left iliofemoral DVT that can be accompanied either with or without a pulmonary embolism (PE) . Patients that develop a left‐sided DVT in the context of MTS are typically young adults that exhibit sudden swelling of the left lower extremity following surgery, during immobilization, or during pregnancy and/or the postpartum period . The occurrence of MTS in adolescents has also been documented in various case reports .…”

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“…Although the prevalence of MTS is unknown, it occurs in 2-5% of patients undergoing evaluation for lower extremity venous disorder [2]. MTS is somewhat related to DVT considering the fact that DVT is more commonly involved in the left popliteal or femoral vein than the right side [3]. The compression of the LCIV may be asymptomatic, and may be found incidentally in most case.…”