Deep Venous Disease – Deep Vein Disorders
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What is May-Thurner syndrome?
May-Thurner syndrome (MTS) is an anatomically and pathologically variable condition leading to venous outflow obstruction as a result of external venous compression. With partial venous obstruction, the condition can be asymptomatic, but progression with symptoms related to chronic venous hypertension or venous occlusion can occur, with or without venous thrombosis. It is important to keep this condition in mind whenever a patient presents acutely with lower extremity swelling or deep vein thrombosis (DVT), particularly in young women.
May-Thurner syndrome (MTS) is defined as extrinsic venous compression by the arterial system against bony structures in the iliocaval territory. MTS is also referred to as iliocaval venous compression syndrome, iliac vein compression syndrome, Cockett’s syndrome, and venous spur. The most common variant of MTS is due to compression of the left iliac vein between the overlying right common iliac artery and the fifth lumbar vertebrae, but others exist.
Diagnosis and Treatment?
The approach to diagnosis and treatment depends upon whether venous thrombosis is present. When the diagnosis is highly suspected based upon clinical features or noninvasive vascular imaging, a definitive diagnosis is established using intravascular ultrasound. Minimally invasive treatment (angioplasty and stenting) of the venous lesion relieves outflow obstruction and provides immediate relief of symptoms with good long-term patency rates. For those with venous thrombosis, rates of post-thrombotic syndrome are reduced with endovascular treatment.
The majority of cases follow the classic left-sided description, but other variants have been reported, such as right-sided MTS and compression of the inferior vena cava (IVC) by the right common iliac artery.
Before & After Stent
On the left hand side you can see the occluded vein with no blood flow. The right side shows the blood flow after a vein sten is placed.
Iliac Vein Compression
What is Iliac Vein Compression?
- The left iliac vein is compressed by the right common iliac artery.
- Refractory swelling, ulcers, leg pain despite conservative measures and medical therapy may be due to a syndrome call May-Thurner syndrome.
- Leg swelling and Leg ulceration
- Pelvic congestion syndrome
- Leg pain on exertion or at rest.
- Your specialized doctor exam
- A special ultrasound inside the deep veins to evaluate the source and degree of obstruction.
- Conservative treatment with compression stockings and leg elevation
- Medical therapy
- Endovenous stent
May-Thurner syndrome is when the Iliac artery compresses the lilac Vein. The first half of this video demonstrates the use of Intravascular Ultrasound (IVUS), which shows a compressed iliac Vein. The second half of the video demonstrates improved blood flow with placement of a Vein Stent in the Iliac Vein. For more information visit our website at www.ivycardiovascular.com and follow us on social media!
Your vein specialist will come up with a customized plan with your input to treat your deep veins.
I was very impressed with Dr Panchal’s professionalism and knowledge of peripheral disease. He is one of the few if not the only one trained in IVUS venogram. This helped diagnose a problem I’ve had for 10 years and will change me life! He and his staff were great and made me feel comfortable and confident. You could tell they truly cared! Thank you Dr Panchal and staff !!
Scott Linder
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The most important step in your care is choosing a vascular specialist to treat your veins. At IVY Cardiovascular and Vein Center our physician, Dr. Rishi Panchal, was trained at Yale, one of five advanced peripheral vascular fellowships in the nation to treat your veins in an academic fashion. We utilize minimally invasive technology to evaluate superficial as well as deep venous disease. We serve all of Palm Beach County and greater South Florida. Current offices in Wellington and Belle Glade, Fl. Call today to set up your consultation.