Out of the Blue Acute May-Thurner Syndrome

Abstract

May-Thurner syndrome (MTS) is defined as extrinsic ilio-femoral venous compression by the aorto-iliac arterial system against vertebral bodies and has been associated with many abnormalities involving the arterial system as well as bony structures around the ilio-caval region. We present an unusual case of a patient who came with phlegmasia cerulea dolens in the setting of acute onset MTS after chiropractic vertebral manipulation and was treated with a multimodal interventional approach, combining pharmaco-mechanical catheter directed thrombectomy along with venoplasty with stenting and subsequent post-procedure anticoagulation and antiplatelet prophylaxis.