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May Thurner syndrome

I Díaz de Santiago, I Insausti Gorbea, M De Miguel Gaztelu, S Albás Sorrosal, J Poblet Florentín, T Rubio Vela
According to scientific evidence, deep venous thrombosis (DVT) is treated with anticoagulation therapy, involving different periods of time depending on the cause. Occasionally, recurrences appear in the same location, with May-Thurner syndrome or Cockett syndrome as one reason, due to compression of the ilio-cava venous system between the vertebral bodies and the arterial system. In these cases, anticoagulation therapy must be maintained during the same time as in the rest of DVT, but as opposed to them, thrombectomy is recommended, with or without the implant of a venous stent in order to avoid recurrence...
February 1, 2019: Anales del Sistema Sanitario de Navarra
Tim Sebastian, Rolf P Engelberger, David Spirk, Lawrence O Hakki, Frederic A Baumann, Rebecca S Spescha, Nils Kucher
BACKGROUND: The optimal duration of anticoagulation therapy (AT) following catheter-based therapy of acute iliofemoral deep vein thrombosis (IFDVT) with stent placement is unknown. Theoretically, resolving the underlying obstructive iliac vein lesion by a stent may eliminate the main trigger for recurrence, the post-thrombotic syndrome (PTS), and the need for extended-duration AT. PATIENTS AND METHODS: From 113 patients with acute IFDVT who underwent endovascular thrombus removal and stent placement, we compared patency rates and clinical outcomes between 58 patients on limited-duration AT (3-12 month) and 55 patients on extended-duration AT (> 12 months)...
January 22, 2019: VASA. Zeitschrift Für Gefässkrankheiten
Leslie J Padrnos, David Garcia
Background: May-Thurner Syndrome (MTS) is caused by compression of the left common iliac vein between the right common iliac artery and the pelvis. It likely predisposes an individual to lower extremity deep vein thrombosis (DVT) as well as symptoms of unilateral lower extremity swelling and discomfort in the absence of a known history of thrombosis. In the case of MTS-associated acute thrombosis, there is low-quality evidence to suggest that endovascular intervention including thrombolysis and endovascular stent placement reduces the risk of recurrent thrombosis...
January 2019: Research and Practice in Thrombosis and Haemostasis
Ricardo Lopez, Randall DeMartino, Mark Fleming, Haraldur Bjarnason, Melissa Neisen
OBJECTIVE: The use of catheter-directed thrombolysis (CDT) may provide clinical benefit in patients with acute deep venous thrombosis (DVT), but significant doubt remains about its indications and risks. We assessed technical success in resolution of acute iliofemoral or central DVT after single-session treatment with a novel mechanical aspiration thrombectomy device as an alternative to initiation of CDT. METHODS: This was a single-center retrospective review of patients with acute iliofemoral or central DVT treated with the Indigo continuous aspiration mechanical thrombectomy 8 system (Penumbra, Inc, Alameda, Calif) from 2016 to 2017...
January 10, 2019: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Arjun Jayaraj, William Buck, Alexander Knight, Blake Johns, Seshadri Raju
OBJECTIVE: May-Thurner syndrome (MTS) patients with lifestyle-limiting symptoms undergo stenting of the iliac vein for relief of compressive disease. The impact of degree of stenosis on clinical symptoms and outcomes after stenting is unknown and examined in our study. METHODS: Retrospective review of contemporaneously entered data of 202 patients who underwent stenting for MTS between 2005 and 2011 was performed. Classification into three groups based on luminal area obtained by intraoperative intravascular ultrasound interrogation of the involved femoroiliocaval segments was carried out...
December 12, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Bill S Majdalany, Natosha Monfore, Minhaj S Khaja, David M Williams
INTRODUCTION: Chronically occluded venous stents may be difficult to salvage, necessitating multiple approaches and adjunctive techniques. Radiofrequency wires have been used to cross chronic obstructions in a variety of settings. Herein, radiofrequency wire recanalization (RFWR) of chronically occluded venous stents is presented. MATERIALS AND METHODS: Fifteen patients (8 males; 7 females) aged 23-74 years (median 42 years) underwent prior venous stenting in the setting of venous occlusions...
January 2019: Cardiovascular and Interventional Radiology
Robert P Liddell, Natalie S Evans
No abstract text is available yet for this article.
October 2018: Vascular Medicine
Timme M A J van Vuuren, Ralph L M Kurstjens, Cees H A Wittens, Jorinde H H van Laanen, Rick de Graaf
OBJECTIVE: Iliac vein compression syndrome can cause severe leg symptoms. In clinical practice, it remains a challenge to differentiate which compression is clinically relevant. The aim of the current study was to assess the general treatment indications and the prevalence of angiographic signs of iliac vein compression in a group of healthy participants. METHODS: This was a prospective cohort study. A total of 20 healthy volunteers (median age 21, range 20-22 years) were recruited through advertisement and underwent angiography of the iliac veins...
December 2018: European Journal of Vascular and Endovascular Surgery
Manohar N M Bhat, Rohit Vadala, Ebenezer Rabindrarajan, Nagarajan Ramakrishnan
May-Thurner syndrome (MTS) or iliac vein compression syndrome is an uncommon cause of deep venous thrombosis (DVT) of the lower limb occurring, especially on the left side. It occurs due to compression of the left common iliac vein by the right common iliac artery and occurs predominantly in young females. The awareness of such a presentation is essential to guide therapy. We report one such unusual case of acute-onset DVT of the left lower limb due to MTS.
July 2018: Indian Journal of Critical Care Medicine
Salman Khalid, Young Jin Youn, Michael Azrin, Juyong Lee
May-Thurner syndrome (MTS) refers to venous outflow obstruction caused by extrinsic compression of the left common iliac vein (LCIV) by the overlying pulsatile right common iliac artery against lumbar vertebrae. The classic clinical presentation is acute unilateral left leg painful swelling due to deep venous thrombosis in a young woman in the second or third decade of life. We present a case of a 66-year-old woman who presented with late-onset left leg swelling caused by nonthrombotic venous hypertension due to degenerative lumbar disc bulge leading to LCIV compression against the left common iliac artery which was confirmed by computed tomography and intravascular ultrasound...
August 9, 2018: Vascular and Endovascular Surgery
Ashraf Odeh Alshabatat, Mohammad Esmaeil Barbati, Omran Alzoubi, Houman Jalaie, Cees H A Wittens
BACKGROUND: May-Thurner syndrome (MTS) leads to an increased incidence of deep vein thrombosis (DVT). Early thrombus removal decreases the post-thrombotic morbidities. Our aim was to better elucidate the relationship between MTS and venous patency after catheter-directed thrombolysis (CDT). METHODS: The medical records of all patients who underwent CDT from January 2005 to December 2011 due to acute DVT were reviewed retrospectively. Patient characteristics and clinical variables were evaluated to determine association with vein patency...
August 6, 2018: Annals of Vascular Surgery
Sidra Khalid, Aariez Khalid, Tessy Meridores, Hamed Daw
May-Thurner syndrome (MTS) is a medical condition where the left iliac vein is compressed by the right iliac artery, which in turn predisposes patients to deep venous thrombosis (DVT). We present a case of a 67-year-old female who had pain and swelling of the left leg. Ultrasound of the deep veins of the leg revealed DVT of the distal external iliac vein. She was treated with catheter-directed thrombolysis and stent placement. Finally, she was discharged on long-term anticoagulation with warfarin. The purpose of presenting this case is to highlight the clinical presentation, diagnosis, and treatment of MTS...
May 29, 2018: Curēus
Dominika M Zoltowska, Guramrinder Thind, Yashwant Agrawal, Vishal Gupta, Jagadeesh Kumar Kalavakunta
May-Thurner syndrome is an underrecognized anatomical variant that can lead to increased propensity for venous thrombosis in the lower extremities. We present a case of a 67-year-old female who presented with transient ischemic attack. Initial workup including CT scan of the head, MRI scan of the head, and magnetic resonance angiogram of the head and neck was unremarkable. A transthoracic echocardiogram with bubble study was also normal. Subsequently, a transesophageal echocardiogram was performed that revealed a patent foramen ovale with right-to-left shunt...
2018: Case Reports in Cardiology
Elizabeth G Lieberman, Courtney D Bell, Andrea Herzka
CASE: A 20-year-old woman underwent hip arthroscopy with a labral repair, a femoral neck osteoplasty, and acetabular rim trimming. Six weeks after surgery, she presented with leg pain and edema, and was found to have an extensive deep vein thrombosis (DVT). Additional imaging studies revealed apparent extrinsic compression of the left common iliac vein, a vascular anatomic variant consistent with May-Thurner syndrome (MTS). CONCLUSION: Thromboembolic events in patients undergoing low-risk procedures should raise concern for additional risk factors, including MTS...
July 25, 2018: JBJS Case Connector
Joerg Herold, Maciej Pech
No abstract text is available yet for this article.
June 29, 2018: Deutsches Ärzteblatt International
Atsushi Funatsu, Hitoshi Anzai, Kota Komiyama, Kuniomi Oi, Hiroshi Araki, Yasuhiro Tanabe, Masashi Nakao, Makoto Utsunomiya, Atsushi Mizuno, Michiaki Higashitani, Shigeru Nakamura
The outcomes of stent implantation in managing May-Thurner syndrome (MTS) are not well understood. To clarify the acute and long-term outcomes of stent implantation in patients with MTS having acute deep venous thrombosis (DVT), we retrospectively investigated consecutive 59 patients from 10 hospitals in Japan who were treated with stents for left iliac vein stenosis with acute DVT. Stents were considered successful if the stent was patent at discharge, which in turn was defined as patient success. The primary endpoint for the study was stent patency, and the secondary endpoint was recurrence of DVT and development of post-thrombotic syndrome (PTS) during follow-up...
June 8, 2018: Cardiovascular Intervention and Therapeutics
C Y Maximilian Png, Kenneth R Nakazawa, Ignatius H Lau, Rami O Tadros, Peter L Faries, Windsor Ting
Venous complications of iliac artery aneurysms are rare. We report the case of bilateral iliac aneurysms that resulted in iliac vein outflow obstruction despite endovascular aneurysm repair. In our patient, bilateral iliac vein stenting resulted in symptom resolution.
September 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
A V Pokrovskiĭ, I M Ignat'ev, E G Gradusov
OBJECTIVE: The purpose of the study was to assess the immediate and remote results of endovascular treatment of obstructive lesions of the veins of the iliofemoral segment. PATIENTS AND METHODS: We performed balloon angioplasty and stenting for iliofemoral venous thrombosis in a total of 75 patients. Of these, 60 patients were subjected to stenting of post-thrombotic obstructions and 15 patients underwent stenting of non-thrombotic obstructive lesions of the iliac veins (for May-Thurner syndrome - in 11, for extravasal tumour-induced compression and cicatricial stenosis - in 4)...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Song Jin, Ziqiang Sun, Xiaoqin Li, Tao Jian, Xing Jin, Sheng Li, Guodong Wang, Chong Ma, Kai Cui, Peng Xu
OBJECTIVE: Pulmonary embolism (PE) is the most common complication of deep venous thrombosis (DVT). May-Thurner syndrome (MTS) is known to increase the risk of DVT, but an association between MTS and PE has not been established. This study investigated an association between MTS and the risk of PE in patients with acute lower extremity DVT. METHODS: Between June 2014 and September 2016, there were 112 patients with DVT at our hospital who underwent venous angiography and computed tomography pulmonary angiography...
July 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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