Diagnosis and Endovascular Treatment of May-Thurner Syndrome

Her, Keun; Lee, Jae Wook; Shin, Hwa Kyun; Won, Yong Soon

Abstract

BACKGROUND: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. MATERIAL AND METHOD: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was 57.6+/-2 years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. RESULT: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients.
CONCLUSION
It is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.