Nonnegligible causes of symptoms of acute lower extremities——3 cases of May-Thurner syndrome with deep vein thrombosis

Abstract

Background May-Thurner syndrome is a kind of disease caused by the compression of the left common iliac vein. It is one of the causes of incomplete venous valves and superficial varicose veins in lower limbs, and is also a potential factor of acute deep vein thrombosis (DVT). Method Here 3 cases are diagnosed as May-Thurner syndrome at different ages. Case presentations 1. A 35-year-old female patient was hospitalized with swelling of the left lower limb for 1 week. Computed tomography (CT) showed compression of the left common iliac vein with thrombosis. May-Thurner syndrome was diagnosed and catheter-directed thrombolysis was performed. 2. A 37-year-old male patient came to our hospital due to sudden swelling of the right lower extremity and pain for 3 days. Computed tomography showed compression of the left common iliac vein and deep venous thrombosis (DVT) of the right iliac vein. May-Thurner syndrome was diagnosed. The patient was performed with inferior vena cava (IVC) filter implantation, catheter-directed thrombolysis and balloon angioplasty for right iliac vein. And the patient recovered well; 3. A 55-year-old female patient came to our hospital with swelling and discomfort in the left lower extremity for 3 days. Computed tomography showed stenosis of the left common iliac vein with deep vein thrombosis. May-Thurner syndrome was diagnosed, balloon dilation and stent implantation were performed. During 3 years of follow-up, there was no swelling or new thrombosis in her lower limbs. Conclusion When encountering unexplained deep vein thrombosis, iliac vein compression syndrome should be considered and treated in time to prevent the recurrence of thrombosis. Catheter-directed thrombolysis can relieve symptoms and stenting placement is the optimal way to relieve stenosis, supplemented by long-term anticoagulation therapy and graduated compression stockings.

Is the May-Thurner Syndrome a Major Risk Factor for Deep Vein Thrombosis in Total Hip Arthroplasty?

“…Although there is no guideline for the diagnosis of MTS, it follows the general guideline of DVT diagnosis in the lower extremity. 19) In general, postoperative DVT mostly occurs in the leg that underwent operation. However, postoperative DVT can occur on the opposite side in MTS.…”

“… 22) Although these methods have advantages for the diagnosis of MTS, they are not suitable for patients with renal disease due to radiation and contrast medium. 19) However, since morbidity and mortality can significantly increase if MTS is not diagnosed, imaging studies should be performed on MTS if suspected in DVT patients after THA. Moreover, preoperative evaluation with duplex sonography or CT angiography to confirm the MTS should be considered.…”

“…The effect of thrombolysis can be evaluated by venography. 19) In the case of iliac vein stenosis, PTA or stent implantation is an effective treatment. 23) Stent implantation should be performed when the stenosis exceeds 70%.…”

“… 25) An IVC filter can be inserted to prevent pulmonary embolism. 19) After mechanical thrombolysis or stent implantation, anticoagulation therapy is necessary for preventing relapse. 26) In this study, after mechanical thrombolysis, PTA, or IVC filter insertion, the patients were treated with anticoagulation therapy.…”

Acquired Immunodeficiency Syndrome (AIDS)-Related Kaposi’s Sarcoma in Conjunction With Methicillin-Resistant Staphylococcus aureus (MRSA) and May-Thurner Syndrome

“…This can often cause venous valve insufficiency where blood pools in the legs and varicose veins in the lower extremities. Some of the most common clinical symptoms are deep vein thrombosis, edema, pain, varicose veins, and ulcers in the left lower limb [ 1 ]. Fibrous changes in the venous wall structure can also sometimes be observed [ 2 ].…”