May Thurner Syndrome: A Case Report and its Endovascular Management

Abstract

May Thurner syndrome (MTS) is an anatomical variant in which right common iliac artery compresses the left common iliac vein against the lumbar vertebrae resulting in Deep Venous Thrombosis (DVT) of left lower limb in patients with no obvious cause. It is most common in middle-aged women. This is a case report of 48-year-old female who came with complaint of progressively increasing swelling of her left lower limb since one week duration with occasional mild pain. Venous Doppler and CT venogram were done, which suggested MTS, for which she underwent percutaneous transluminal angioplasty and stenting to the left common iliac vein. Immediately after this procedure, the left lower limb venous blood flow returned to normal with some residual thrombus in popliteal vein. Doppler ultrasonography was done after four months which showed patent stent with smooth flow across it and with ~60-70% recanalisation in external iliac vein, common femoral and femoral vein; ~70-80% recanalisation in popliteal vein. The present case report emphasises that MTS should be considered as a cause of acute left lower limb DVT in middle-aged women without any predisposing factors and endovascular treatment (Percutaneous transluminal angioplasty with stenting) is the most practical and effective method of treatment.

Keywords

• left common iliac vein
• left lower limb dvt
• percutaneous transluminal angioplasty and stenting