Treatment of May-Thurner
The majority of symptoms treated by a vascular surgeon are caused by atherosclerosis. However, sometimes patients develop symptoms simply due to the consequence of anatomy such as with May-Thurner Syndrome. May-Thurner syndrome causes left leg edema and sometimes even DVT secondary to the right iliac artery compressing the left iliac vein. When the left iliac vein is compressed it prevents blood flowing back to the heart from the left leg. This causes swelling and stasis or poor blood movement, which can cause deep vein thrombosis (DVT). Despite the narrowing of the iliac vein, it is still possible to have a pulmonary embolism with May-Thurner syndrome. While some patients have minimal symptoms, others find their symptoms are exacerbated by pregnancy, weight gain, or even long periods of travel.
Although treatment of May-Thurnersyndrome is usually approached endovascularly, it is important that underlying issues such as DVT are treated first. Patients usually present with unilateral leg swelling. Ultrasound is the diagnostic test of choice to confirm a DVT. Once diagnosed these patients are started on anticoagulation. Patients with May-Thurner syndrome often have iliac vein DVTs. These patients usually benefit from thrombolysis and rheolytic therapy. Depending on the patient’s health and the extent of disease, these patients either return for endovascular treatment as an outpatient or during their initial hospital stay. After the majority of the clot has been dissolved, the surgeon can image the iliac veins using intravascular ultrasound (IVUS). IVUS uses ultrasound from the inside of the vessel. In patients with May-Thurner syndrome it will show a narrowing of the left iliac vein with obvious compression by the overlying right iliac artery. This area of compression must be fully expanded to allow adequate blood return. This is done with balloons and stents. The stent will prop open the vein and prevent further compression by the artery. This expansion of the vein should not only resolve the symptoms of the patient but also prevent the symptoms from developing in the future.
The success of any surgical procedure depends on a wide variety of factors. These include the comorbidities surrounding the circumstances of the surgery, the training and experience of the surgeon, and the extent of disease. Any patient looking for treatment of May-Thurner should seek the services of a fantastic vascular surgeon. For patients located on the West coast of Florida from Riverview to Sarasota looking for a phenomenal vascular surgeon, look no further than Dr. Jenna Kazil at the Florida Surgical Clinic located in Manatee County, Florida. Dr. Kazil is a vascular surgeon in Bradenton who has experience treating patients with May-Thurner and numerous other medical conditions. Contact the Florida Surgical Clinic today to schedule an appointment with a surgical specialist for any general and vascular surgery needs.
