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May-Thurner Syndrome

May-Thurner syndrome (MTS), also called iliac vein compression syndrome is known to increase the risk of deep vein thrombosis (DVT) especially in the left extremity.   Patients may experience symptoms over several months to many years before being referred by their primary physician to The Minnesota Vein Center specialists for evaluation.  This condition is known to occur three times more frequently in women than in men.

The syndrome is most commonly caused when the left iliac (pelvic) vein is compressed by the right iliac artery.  Pressure exerted by the right iliac artery forces the left iliac vein to narrow and sometimes scar.  This vein compression may cause signs and symptoms which often include leg pain, leg swelling, varicosities (especially upper thigh) and also increases the risk of deep vein thrombosis (DVT), a blood clot that may partially or completely block blood flow through the vein.

May-Thurner syndrome has no known identifiable risk factors.  However, the condition is found most commonly in young women, especially those who are taking birth control pills, or during or after pregnancy. Patients with May- Thurner syndrome have symptoms which overlap with those of deep vein thrombosis, so obtaining a proper diagnosis by a physician with expertise in venous conditions is important.

The diagnostic tests commonly used to look for May-Thurner syndrome include ultrasound, magnetic resonance imaging (MRI), computed tomography (CT) scan and venography.

May- Thurner syndrome treatment may include:

  • Anticoagulation medication for clot treatment and improved blood flow through the iliac vein.
  • Directed (catheter) clot therapy injections designed to dissolve blood clots in the compressed veins using medication/injections with or without mechanical device techniques.
  • A combination of angioplasty and stent placement to stretch open a compressed vein after clot dissolving treatment. (Stents also may serve to prevent future iliac vein narrowing in the future.)

The prognosis for patients who do seek treatment for suspected symptomatic May-Thurner syndrome is good, especially if the compressed vein is detected early. Many people have some degree of  iliac vein compression yet  have no symptoms or complications.   Patients should, however, see a doctor immediately if they notice signs of vein compression or if they think they have symptoms of deep vein thrombosis.

For more information about blood clots and other vein conditions, contact Minnesota Vein Center to consult with Dr. Pal, a specialist who can identify suspected May-Thurner and other complicated conditions.  Dr. Pal will be able to evaluate your May-Thurner syndrome symptoms and procure a proper diagnosis to help you obtain best treatment options.

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