The Myth of May Thurner

Abstract

Less invasive contemporary endovenous techniques with improved stents have made treatment of the May Thurner Syndrome(MTS) more accessible and safer. However, clear criteria for the accurate diagnosis remain obscure. All imaging modalities are performed with patients in a supine position were compression of the left Common Iliac Vein is seen in both asymptomatic and symptomatic patients. There is no clear threshold value. There are no validated hemodynamic criteria. This leads to the necessity of additional information such as measurements performed in an upright position as well as greater scrutiny in detecting fibrous wall thickening and spurs as well as identifying the presence of venous collaterals. Moreover, those contemplating treating MTS should not only identify specific symptoms, but also should consider that patient complaints may be related to a more complex presentation of pelvic congestion.

Zusammenfassung

Durch weniger invasive, moderne endovenöse Techniken mit verbesserten Stents ist eine bessere und sicherere Behandlung des May-Thurner-Syndroms (MTS) möglich. Klare Kriterien für die genaue Diagnose sind jedoch nach wie vor nicht festgelegt. Bildgebende Verfahren werden in Rückenlage durchgeführt, wobei eine Kompression der linken Iliakalvene sowohl bei asymptomatischen als auch bei symptomatischen Patienten beobachtet wird – es gibt keinen eindeutigen Schwellenwert. Zudem gibt es gibt keine validierten hämodynamischen Kriterien. Aufgrund dessen ist die Erhebung zusätzlicher Informationen notwendig: Es sollten Messungen in aufrechter Position sowie genauere Untersuchungen fibröser Wandverdickungen, des Beckenvenensporns und venöser Kollaterale durchgeführt werden. Darüber hinaus sollten Ärzte, die das MTS behandeln, sich nicht nur auf spezifische Symptome konzentrieren, sondern bedenken, dass den Beschwerden auch eine komplexere Darstellung des pelvinen Stauungssyndroms zugrunde liegen kann.

Key words

May Thurner - compression - iliac vein - spur

Schlüsselwörter

May Thurner - Kompression - Iliakalvene - Beckenvenensporn

Publication History

Article published online:
22 July 2020

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