Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 24 , ISSUE 1 ( January, 2020 ) > List of Articles

CASE REPORT

May-Thurner Syndrome: A Forgotten Cause of Venous Thromboembolism

Archana Baburao, Ajay Babu, Ankit Pandey

Keywords : Deep vein thrombosis, May-Thurner syndrome, Pulmonary embolism

Citation Information : Baburao A, Babu A, Pandey A. May-Thurner Syndrome: A Forgotten Cause of Venous Thromboembolism. Indian J Crit Care Med 2020; 24 (1):66-68.

DOI: 10.5005/jp-journals-10071-23331

License: CC BY-NC 4.0

Published Online: 01-01-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

The annual incidence rates of venous thromboembolism are approximately 1 per 1,000 persons per year in adult population. Deep vein thrombosis (DVT) most frequently occurs in the setting of underlying illness, and anatomical abnormalities are rarely considered as an etiology for it. A well-described anatomical cause for DVT is “May-Thurner syndrome” (MTS), which occurs as a result of compression of the left common iliac vein by the overlying right common iliac artery. This syndrome most often affects young to middle-aged women. Pulmonary embolism (PE) occurs very rarely in these patients. Anticoagulation therapy alone is not enough in these patients. We report a case of 27-year-old male who had both left DVT and PE caused by MTS and was treated with endovascular management along with long-term anticoagulation.


PDF Share
  1. Kibbe MR, Ujiki M, Goodwin AL, Eskandari M, Yao J, Matsumura J. Iliac vein compression in an asymptomatic patient population. J Vasc Surg 2004;39(5):937–943. DOI: 10.1016/j.jvs.2003.12.032.
  2. O’Sullivan GJ, Semba CP, Bittner CA, Kee ST, Razavi MK, Sze DY, et al. Endovascular management of iliac vein compression (May–Thurner) syndrome. J Vasc Interv Radiol 2000;11(7):823–836. DOI: 10.1016/S1051-0443(07)61796-5.
  3. May R, Thurner J. The cause of the predominately sinistral occurrence of thrombosis of the pelvic veins. Angiology 1957;8:419–427. DOI: 10.1177/000331975700800505.
  4. McMurrich JP. The occurrence of congenital adhesions in the common iliac veins and their relation to thrombosis of the femoral and iliac veins. Am J Med Sci 1908;135:342–346. DOI: 10.1097/00000441-190803000-00004.
  5. Cockett FB, Thomas LM. The iliac compression syndrome. Br J Surg 1965;52:816–821. DOI: 10.1002/bjs.1800521028.
  6. Chan KT, Popat RA, Sze DY, Kuo WT, Kothary N, Louie JD, et al. Common iliac vein stenosis and risk of symptomatic pulmonary embolism: An inverse correlation. J Vasc Interv Radiol 2011;22(2):133–141. DOI: 10.1016/j.jvir.2010.10.009.
  7. Fasanya AA, Lacapra G. May–Thurner syndrome with pulmonary embolism as the first presentation rather than deep vein thrombosis. Cureus 2016;8(2):e509. DOI: 10.7759/cureus.509.
  8. Thijs W, Rabe KF, Rosendaal FR, Middeldorp S. Predominance of left-sided deep vein thrombosis and body weight. J Thromb Haemost 2010;8(9):2083–2084. DOI: 10.1111/j.1538-7836.2010.03967.x.
  9. Fazel R, Froehlich JB, Williams DM, Saint S, Nallamothu BK. Clinical problem-solving. A sinister development—a 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma. N Engl J Med 2007;357(1):53–59. DOI: 10.1056/NEJMcps061337.
  10. Ibrahim W, Safran ZAI, Hasan H, Zeid WA. Endovascular management of May–Thurner syndrome. Ann Vasc Dis 2012;5(2):217–221. DOI: 10.3400/avd.cr.12.00007.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.