May-Thurner syndrome is not only a left-sided condition–Consideration of venous anatomical variations

Abstract

May Thurner Syndrome (MTS11 The abbreviation “MTS” will refer to May Thurner Syndrome throughout this manuscript.) was historically described as a cause of left-sided DVT, but case reports of MTS venous anomalies have highlighted variations in clinical presentation. This case describes a 39-year-old woman who presented with unilateral right leg swelling and redness, found to be ‘right-sided’ MTS. Diagnostic imaging revealed right deep vein thrombosis (DVT), caused by compression of the right common iliac vein from tributaries of an anatomically aberrant left-sided inferior vena cava. Treatment course was prolonged by patient desire for additional time to weigh options; ultimately she developed re-thrombosis of the iliac vein with subsequent right iliac vein stenting. Although MTS may be a less common cause of DVT at the population level, this case demonstrates a need to maintain high suspicion for young patients without other clear predisposing factors.

Keywords

• May Thurner syndrome
• Deep venous thrombosis
• Venous anatomical anomaly