Case Reports in Vascular Medicine (Jan 2019)

May-Thurner Syndrome with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches

  • Lori Jia,
  • Jason Alexander,
  • Nedaa Skeik

DOI
https://doi.org/10.1155/2019/7079307
Journal volume & issue
Vol. 2019

Abstract

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May-Thurner syndrome (MTS) is a venous outflow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.