Osteophytic Iliac Venous Compression: Technical Considerations for a Bony May-Thurner Syndrome Variant

Shin, David S.; Mokkarala, Mahati; Allison, Stephen K.; Monroe, Eric J.

doi:10.1055/s-0038-1667208

Cited by 4 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[30][31][32] Although the stent placement at the stenotic area is main treatment for MST, bony MTS creates a solider occupancy effect from the degenerated lumbar structures and sharper compression with fulcrum effect compared to the simple MTS. 10,33 For these reasons, a stent with higher radial force may be suited for bony MTS to achieve durable patency, and if the osteophytes are accessible, surgical excision of osteophyte also can be considered. 10,34 It will be important to determine appropriate treatment by identifying anatomical features of MTS by CTV.…”

Section: Discussionmentioning

confidence: 99%

“…10,33 For these reasons, a stent with higher radial force may be suited for bony MTS to achieve durable patency, and if the osteophytes are accessible, surgical excision of osteophyte also can be considered. 10,34 It will be important to determine appropriate treatment by identifying anatomical features of MTS by CTV.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9] However, bony structures affecting venous compression have not been fully investigated and are thought to occur more frequently in elderly patients with degenerative spondylosis. 10,11 In general, if there is left-sided clinical symptom such as swelling and pain, it is highly suspected of iliac vein compression, and several studies may be accompanied with physical examination. 13,14 Catheter venography is considered a reference standard and intravascular ultrasound is accurate diagnostic modalities, but these studies are invasive and cannot provide extravascular cause of compression.…”

Section: Introductionmentioning

confidence: 99%

“…3–9 However, bony structures affecting venous compression have not been fully investigated and are thought to occur more frequently in elderly patients with degenerative spondylosis. 10,11…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Acute left iliofemoral vein thrombosis: Comparison between simple and bony May-Thurner syndrome in CT venography

et al. 2022

View full text Add to dashboard Cite

Objectives To explore the etiology of May-Thurner syndrome (MTS) with acute iliofemoral deep vein thrombosis (DVT) regarding imaging findings and clinical features. Methods We retrospectively analyzed 57 patients with acute left iliofemoral DVT from 2015 to 2020. The diameter of left common iliac vein (LCIV) at the maximal compression site and its percent compression regarding the average diameter of the uncompressed iliac vein were recorded in central and distal portions of the LCIV according to the location in the quadrant of lumbar vertebral body. Compression was categorized into simple and bony MTS; Simple MTS as LCIV compressed by the right common iliac artery (RCIA) versus Bony MTS as LCIV by lower lumbar degenerative changes regardless of RCIA compression. Initial computed tomographic venography (CTV) regarding chronic change of LCIV such as fibrotic atrophy or cordlike obliteration, extent of thrombus, and lumbar degenerative changes were evaluated. Therapeutic effect after initial therapy was assessed in follow-up CTVs after 3–6 months. Results All patients showed LCIV compression with 19 simple MTS (mean age, 42.8 ± 14.1 years [23–67 years]; 12 females; symptom for 4.4 ± 5.5 days) and 38 bony MTS (mean age, 73.0 ± 10.2 years [49–85 years]; 26 females; symptom for 5.5 ± 4.8 days). There was significant difference in age ( p < .001) and no significant difference in sex or symptom duration between two groups ( p = .691 and 0.415, respectively). All simple MTS showed compression only in the central LCIV and half of bony MTS showed compression in both central and distal LCIV ( p < .001). Among the lumbar degenerative changes, symmetric anterolateral osteophyte ( p < .001) and asymmetric osteophyte ( p < .001) were significantly associated with bony MTS, but not scoliosis ( p = .799), compared to simple MTS. Although there was no significant difference in chronic change of LCIV, thrombosis extent, and therapeutic effect between two groups ( p > .05), chronic change of LCIV showed significant difference between single and dual compression (23.7% vs. 57.9%, p = .024) and residual thrombus after initial therapy was occurred in 21.1% of single compression and 47.4% in dual compression with non-significant trend ( p = .082). Conclusion Bony MTS related to lumbar degenerative changes with acute iliofemoral DVT occurs in older patients, presenting more than one stenosis at LCIV, inducing more chronic change with possibly weaker therapeutic effect than simple MTS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute left iliofemoral vein thrombosis: Comparison between simple and bony May-Thurner syndrome in CT venography

et al. 2022

View full text Add to dashboard Cite

show abstract

“…It is more commonly seen as the classic May-Thurner syndrome, in which the left common iliac vein is compressed by the right common iliac artery. Other rare and less frequent causes of extrinsic compression of the iliac veins have been described 1, 2. Venous outflow obstruction in combination with repetitive microtrauma to the iliac vein predisposes patients to recurrent venous thrombosis or nonthrombotic symptoms.…”

mentioning

confidence: 99%

Lumbosacral exostosis as a rare cause of iliac vein compression and significant limb swelling

Wasserburger

Haponyuk

Modhia

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

A 67-year-old woman presented to our vein clinic for chronic left lower extremity edema, pain, and varicosities. After failed conservative management, a computed tomography scan revealed central venous stenosis secondary to compression of the left common iliac vein by a large osteophyte along the anterolateral aspect of the L5-S1 disk space. An anterior osteophytectomy was performed, followed by iliac venous stenting at a 1-month interval. The patient had resolution of symptoms and remains symptom free at 15 months of follow-up. This report describes a spinal exostosis causing symptomatic venous compression successfully relieved by surgical decompression.

show abstract

Iliac vein compression syndrome by lumbar degenerative changes is associated with deep vein thrombosis after total knee arthroplasty

Kim

Lee

Kim

2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Osteophytic Iliac Venous Compression: Technical Considerations for a Bony May-Thurner Syndrome Variant

Cited by 4 publications

References 9 publications

Acute left iliofemoral vein thrombosis: Comparison between simple and bony May-Thurner syndrome in CT venography

Acute left iliofemoral vein thrombosis: Comparison between simple and bony May-Thurner syndrome in CT venography

Lumbosacral exostosis as a rare cause of iliac vein compression and significant limb swelling

Iliac vein compression syndrome by lumbar degenerative changes is associated with deep vein thrombosis after total knee arthroplasty

Contact Info

Product

Resources

About