Osteophytic Iliac Venous Compression: Technical Considerations for a Bony May-Thurner Syndrome Variant

Abstract

May-Thurner syndrome (MTS) results in compression of the left common iliac vein between the spine and right common iliac artery leading to symptomatic venous outflow obstruction. The authors depict a classic case of MTS followed by four variant cases in which the primary culprit lesions causing compression were degenerative vertebral osteophytes. The osteophytic variant of MTS poses distinct diagnostic and therapeutic challenges.

Keywords

May-Thurner syndrome - venous compression - osteophyte - thrombolysis - stent

• References

• 1 May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology 1957; 8 (05) 419-427
• 2 Cockett FB, Thomas ML, Negus D. Iliac vein compression—its relation to iliofemoral thrombosis and the post-thrombotic syndrome. BMJ 1967; 2 5543 14-19
• 3 Butros SR, Liu R, Oliveira GR, Ganguli S, Kalva S. Venous compression syndromes: clinical features, imaging findings and management. Br J Radiol 2013; 86 1030 20130284
• 4 Kim JY, Choi D, Guk KoY, Park S, Jang Y, Lee DY. Percutaneous treatment of deep vein thrombosis in May-Thurner syndrome. Cardiovasc Intervent Radiol 2006; 29 (04) 571-575
• 5 Wax JR, Pinette MG, Rausch D, Cartin A. May-Thurner syndrome complicating pregnancy: a report of four cases. J Reprod Med 2014; 59 (05) [phone]
• 6 Murphy EH, Davis CM, Journeycake JM, DeMuth RP, Arko FR. Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner Syndrome. J Vasc Surg 2009; 49 (03) 697-703
• 7 Urschel Jr HC, Patel AN. Surgery remains the most effective treatment for Paget-Schroetter syndrome: 50 years’ experience. Ann Thorac Surg 2008; 86 (01) 254-260 discussion 260
• 8 Nwoke F, Picel AC. May-Thurner syndrome and horseshoe kidney. J Vasc Interv Radiol 2016; 27 (03) 369
• 9 Young L, Kwon J, Arosemena M, Salvatore D, DiMuzio P, Abai B. Symptomatic compression of right iliac vein after right iliac artery stent placement. J Vasc Surg Venous Lymphat Disord 2017; 5 (05) 735-738
• 10 Woo EJ, Ogilvie RA, Krueger VS, Lundin M, Williams DM. Iliac vein compression syndrome from anterior perforation of a pedicle screw. J Surg Case Rep 2016; 2016 (02) rjw003