Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Phlebothrombosis | Case report

Deep vein thrombosis due to May-Thurner syndrome: a case report

Authors: Yan Meng, Hao Qin, Qiang Ma, Junbo Zhang, Bo Zhang, Honggang Pang, Qian Yin, Hongyan Tian

Published in: BMC Cardiovascular Disorders | Issue 1/2020

Login to get access

Abstract

Background

May-Thurner syndrome (MTS) or Cockett’s syndrome is a rare clinical syndrome, which refers to the compression of the left common iliac vein (LCIV) by right common iliac artery and vertebral body. Complications of MTS include deep vein thrombus formation and even life-threatening pulmonary embolism.

Case presentation

Here, we report the case of a 60-year-old female patient with a complaint of swelling in the left lower limb and pain for 5 days. Computed tomography angiography indicated MTS, and thrombus formation of left external iliac vein and femoral vein. The patient was diagnosed with deep venous thrombosis (DVT) and MTS. The patient underwent ascending venography from the lower extremity to inferior vena cava (IVC) and then to the pulmonary artery with IVC filter implantation, left iliac vein balloon plasty, and stent placement. The patient visited the hospital for the removal of IVC filter, 28 days after the operation. After the interventional therapy, the patient had no in-stent restenosis and had remission during the 2-year follow-up.

Conclusions

This case presents a successful management of MTS in presence of DVT. Although clinicians are rarely aware, the presence of unilateral lower limb swelling and thrombosis may be the manifestations of MTS.
Literature
1.
go back to reference Fazel R, Froehlich JB, Williams DM, Saint S, Nallamothu BK. Clinical problem-solving. A sinister development--a 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma. N Engl J Med. 2007;357:53–9.CrossRef Fazel R, Froehlich JB, Williams DM, Saint S, Nallamothu BK. Clinical problem-solving. A sinister development--a 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma. N Engl J Med. 2007;357:53–9.CrossRef
2.
go back to reference Narayan A, Eng J, Carmi L, McGrane S, Ahmed M, Sharrett AR, et al. Iliac vein compression as risk factor for left- versus right-sided deep venous thrombosis: case-control study. Radiology. 2012;265:949–57.CrossRef Narayan A, Eng J, Carmi L, McGrane S, Ahmed M, Sharrett AR, et al. Iliac vein compression as risk factor for left- versus right-sided deep venous thrombosis: case-control study. Radiology. 2012;265:949–57.CrossRef
3.
go back to reference May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419–27.CrossRef May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419–27.CrossRef
4.
go back to reference DeRubertis B, Patel R. May-Thurner syndrome: diagnosis and management. Curr Manage Venous Dis. 2018;1:463–77.CrossRef DeRubertis B, Patel R. May-Thurner syndrome: diagnosis and management. Curr Manage Venous Dis. 2018;1:463–77.CrossRef
5.
go back to reference Carroll S, Moll S. Inferior vena cava filters, May-Thurner syndrome, and vein stents. Circulation. 2016;133:e383–7.CrossRef Carroll S, Moll S. Inferior vena cava filters, May-Thurner syndrome, and vein stents. Circulation. 2016;133:e383–7.CrossRef
6.
go back to reference Higgs ZC, Macafee DA, Braithwaite BD, Maxwell-Armstrong CA. The Seldinger technique: 50 years on. Lancet. 2005;366:1407–9.CrossRef Higgs ZC, Macafee DA, Braithwaite BD, Maxwell-Armstrong CA. The Seldinger technique: 50 years on. Lancet. 2005;366:1407–9.CrossRef
7.
go back to reference Cockett FB, Thomas ML, Negus D. Iliac vein compression.--Its relation to iliofemoral thrombosis and the post-thrombotic syndrome. Br Med J. 1967;2:14–9.CrossRef Cockett FB, Thomas ML, Negus D. Iliac vein compression.--Its relation to iliofemoral thrombosis and the post-thrombotic syndrome. Br Med J. 1967;2:14–9.CrossRef
8.
go back to reference Ehrich WE, Krumbhaar EB. A frequent obstructive anomaly of the mouth of the left common iliac vein. Am Heart J. 1943;26:737–50.CrossRef Ehrich WE, Krumbhaar EB. A frequent obstructive anomaly of the mouth of the left common iliac vein. Am Heart J. 1943;26:737–50.CrossRef
9.
go back to reference Posner C, Owen M, Melhem N, Vidyarthi M, Low D, Renfrew I, et al. An acutely swollen leg. Clin Med (Lond). 2010;10:484–6.CrossRef Posner C, Owen M, Melhem N, Vidyarthi M, Low D, Renfrew I, et al. An acutely swollen leg. Clin Med (Lond). 2010;10:484–6.CrossRef
10.
go back to reference Mickley V, Schwagierek R, Rilinger N, Gorich J, Sunder-Plassmann L. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg. 1998;28:492–7.CrossRef Mickley V, Schwagierek R, Rilinger N, Gorich J, Sunder-Plassmann L. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg. 1998;28:492–7.CrossRef
11.
go back to reference O'Sullivan GJ, Semba CP, Bittner CA, Kee ST, Razavi MK, Sze DY, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2000;11:823–36.CrossRef O'Sullivan GJ, Semba CP, Bittner CA, Kee ST, Razavi MK, Sze DY, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2000;11:823–36.CrossRef
12.
go back to reference Oguzkurt L, Tercan F, Ozkan U, Gulcan O. Iliac vein compression syndrome: outcome of endovascular treatment with long-term follow-up. Eur J Radiol. 2008;68:487–92.CrossRef Oguzkurt L, Tercan F, Ozkan U, Gulcan O. Iliac vein compression syndrome: outcome of endovascular treatment with long-term follow-up. Eur J Radiol. 2008;68:487–92.CrossRef
13.
go back to reference Bozkaya H, Cinar C, Ertugay S, Korkmaz M, Guneyli S, Posacioglu H, et al. Endovascular treatment of iliac vein compression (May-Thurner) syndrome: angioplasty and stenting with or without manual aspiration Thrombectomy and catheter-directed thrombolysis. Ann Vasc Dis. 2015;8:21–8.CrossRef Bozkaya H, Cinar C, Ertugay S, Korkmaz M, Guneyli S, Posacioglu H, et al. Endovascular treatment of iliac vein compression (May-Thurner) syndrome: angioplasty and stenting with or without manual aspiration Thrombectomy and catheter-directed thrombolysis. Ann Vasc Dis. 2015;8:21–8.CrossRef
14.
go back to reference Mousa AY, AbuRahma AF. May-Thurner syndrome: update and review. Ann Vasc Surg. 2013;27:984–95.CrossRef Mousa AY, AbuRahma AF. May-Thurner syndrome: update and review. Ann Vasc Surg. 2013;27:984–95.CrossRef
15.
go back to reference Budnur SC, Singh B, Mahadevappa NC, Reddy B, Nanjappa MC. Endovascular treatment of iliac vein compression syndrome (May-Thurner). Cardiovasc Interv Ther. 2013;28:101–5.CrossRef Budnur SC, Singh B, Mahadevappa NC, Reddy B, Nanjappa MC. Endovascular treatment of iliac vein compression syndrome (May-Thurner). Cardiovasc Interv Ther. 2013;28:101–5.CrossRef
16.
go back to reference J. Padrnos L, Garcia D. May-Thurner syndrome and thrombosis: A systematic review of antithrombotic use after endovascular stent placement. Res Pract Thromb Haemost. 2018;3:70–8.CrossRef J. Padrnos L, Garcia D. May-Thurner syndrome and thrombosis: A systematic review of antithrombotic use after endovascular stent placement. Res Pract Thromb Haemost. 2018;3:70–8.CrossRef
Metadata
Title
Deep vein thrombosis due to May-Thurner syndrome: a case report
Authors
Yan Meng
Hao Qin
Qiang Ma
Junbo Zhang
Bo Zhang
Honggang Pang
Qian Yin
Hongyan Tian
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01515-z

Other articles of this Issue 1/2020

BMC Cardiovascular Disorders 1/2020 Go to the issue