Some patients have anatomy that predisposes them to medical issues. This is what happens with May-Thurner Syndrome.
Definition of May-Thurner Syndrome
May-Thurner Syndrome develops when the right iliac artery compresses the left iliac vein, inhibiting blood flow through the left iliac vein.
Anatomy of May-Thurner Syndrome
Arteries bring oxygenated blood to the tissues. Veins bring deoxygenated blood back to the heart. In the abdomen, the aorta splits into the left and right iliac arteries. The inferior vena cava splits into the left and right iliac veins. The aorta and vena cava are side by side within the abdomen. When they split the iliac arteries and veins overlap. In May-Thurner syndrome, the left iliac vein is compressed by the overlying iliac artery and causes left leg swelling or even a deep vein thrombosis.
Causes of May-Thurner Syndrome
Many people have anatomy that is consistent with May-Thurner syndrome but don’t have symptoms. It is unclear why some people develop symptoms more than others. Anything that causes excessive pressure in the pelvis such as pregnancy or a tumor seems to exacerbate symptoms.
Symptoms of May-Thurner Syndrome
May-Thurner syndrome causes damage to the left iliac vein. Symptoms include:
- Deep vein thrombosis
- Left leg swelling
- Possible aneurysm development of the iliac vein
- Scarring or narrowing of the left iliac vein
Diagnosis of May-Thurner Syndrome
The syndrome is first identified on an ultrasound that demonstrates the compression of the left iliac vein. Ultrasound can also show any evidence of deep vein thrombosis. If the patient’s body habitus does not allow for adequate visualization using ultrasound, computed tomography (CT) is often used.
Prevention of May-Thurner Syndrome
There is no way to prevent May-Thurner syndrome as it is simply a consequence of anatomy.
Am I At Risk?
May-Thurner syndrome develops as a consequence of anatomy. Pregnancy and pelvic tumors may worsen symptoms. It is known that this syndrome is more common in women.
Treatment of May-Thurner Syndrome
Many patients present with deep vein thrombosis (DVT) and are subsequently found to have May-Thurner Syndrome. These patients need treatment of their DVT prior to treatment of May-Thurner Syndrome. Your surgeon will discuss optimal treatment for your blood clot depending on the extent of a clot and medical history. Most patients respond well to endovascular treatment of May-Thurner syndrome. A balloon or stent is used to expand the iliac vein and stretch any scarred areas. The balloon or stent is placed via a small incision in the groin.
To learn more about treatment procedures for this condition please visit the following:
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