May-Thurner syndrome

What is May-Thurner syndrome?

Also known as iliac vein compression syndrome, May Thurner syndrome (MTS) is a condition in which the left iliac vein in the pelvis is compressed by the overlying right iliac artery. The result of this is an increased risk of deep vein thrombosis (DVT) in the left leg.

Deep vein thrombosis can cause discomfort, but it is not always serious. However, in some cases, it can lead to more serious complications, such as venous insufficiency and life-threatening pulmonary embolism.

Prognosis of the disease

In cases where thrombosis has already occurred, the sequelae and treatment are more complex than if the syndrome is diagnosed before venous thrombosis occurs.

Symptoms of May-Thurner Syndrome

Before thrombosis occurs, the usual symptoms of a pathological compression of the iliac vein are:

  • Tension or congestive sensation of the limb, which increases with exercise and even forces the patient to stop.
  • Swelling in the leg
  • Pain / throbbing
  • Red or purple skin
  • Area of skin that feels particularly warm to the touch.
  • Enlarged veins in the leg.
  • Leg feels heavy.

If DVT causes venous insufficiency, that is, when the veins struggle to return enough blood from the extremities back to the heart, leading to a pooling of blood in the extremities, the following symptoms may appear:

  • Leg pain
  • Swelling
  • Leg ulcers
  • Skin discoloration

If part of the blood clot breaks loose and travels to the lungs, this can cause a pulmonary embolism, a blockage of blood flow in the lungs, which can be fatal, and is considered a medical emergency. You should seek medical attention immediately if you notice the following symptoms:

  • Sudden shortness of breath
  • Stabbing pain in the chest, which may get worse with deep breaths
  • Rapid heart rate
  • Coughing up blood or mucus
  • Fainting
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May-Thurner syndrome is often suffered by thin people, mainly women.

Medical tests for May-Thurner Syndrome

Initially, non-invasive studies will be requested from the patient’s vascular exploration laboratory, through Color EchoDoppler, a tool used both in the diagnosis and follow-up of MTRS. This test performs a non-invasive ultrasound study that shows the structure, movement and function of the blood vessels in real time.

If iliac compression is significant and/or pelvic varices have developed, another radiological study called iliocavography may be necessary, which provides the definitive diagnosis.

What are the causes of May-Thurner syndrome?

The exact origin of this compression is unknown, but it is very common in thin people, mainly women.

Can it be prevented?

Since the origin of May-Thurner syndrome is unknown, it cannot be prevented per se, but once the symptoms appear, the risk of deep vein thrombosis (DVT) can be prevented by applying an appropriate treatment.

Treatments for May-Thurner syndrome

Some patients with May-Thurner syndrome have no complications. In fact, many may not even know they have it, and even if they do know about the condition, no treatment is necessary unless it begins to produce symptoms.

There are filters that are inserted into the vena cava (the largest vein in the body) using a catheter, which help filter the blood going to the lungs, trapping clots and preventing pulmonary embolisms.

In some cases, the physician will recommend minimally invasive surgery, such as balloon angioplasty. In this procedure, a catheter with a balloon at the tip is inserted into the vein. The balloon expands, opening the vein, after which a stent (a small mesh tube) is placed to keep the vein open once the catheter is removed, allowing normal blood flow.

Other surgical options include bypassing the blood around the blocked part of the vein or repositioning the overlying artery.

Which specialist treats you?

Undoubtedly the best option for any vascular pathology is a specialist in Angiology and Vascular Surgery.