Volume : 10, Issue : 08, August – 2023

Title:

08.MANAGEMENT OF DEEP VENOUS THROMBOSIS IN MAY-THURNER SYNDROME CASE REPORT
‬

Authors :

Qais Abbushi, Abrar Nasser Almaghrabi, Mahmoud Amjad Keemawi, Moayad Zeyad Aljuhani

This is a case of a 37-year-old previously healthy female who presented to the hospital with new-onset left leg pain, which was diagnosed and treated as an ankle sprain. Latter on presented with leg swelling and left flank pain; a doppler ultrasound revealed extensive deep venous thrombosis involving the left lower limb, from the common femoral vein to the posterior tibial veins and the greater and lesser saphenous veins. She was started on therapeutic enoxaparin with no response, then she was on heparin infusion, unfortunately without any clinical response. A CT scan of the abdomen was requested before inferior vena cava (IVC) filter insertion revealed compression of the left common iliac vein where it passes behind the left common iliac artery, suggesting May-Thurner syndrome. A decision was made for Catheter-directed Thrombolysis and IVC Filter insertion. The patient underwent mechanical thrombectomy and lysis of a vascular clot, with successful results. The final venogram showed clear patency and no residual clot, and an IVC filter was inserted. The patient is currently stable and has shown improvement in symptoms and mobility.
Key words: Deep venous thrombosis; Iliac vein compression syndrome; May-Thurner syndrome; Thrombolysis; Coagulation disorders.

Cite This Article:

Please cite this article in press Qais Abbushi et al, Management Of Deep Venous Thrombosis In May-Thurner Syndrome Case Report, Indo Am. J. P. Sci, 2023; 10 (08).

Number of Downloads : 10

References:

1. Poyyamoli, S., Mehta, P., Cherian, M., Anand, R. R., Patil, S. B., Kalva, S., & Salazar, G. (2021). May-Thurner syndrome. Cardiovascular diagnosis and therapy, 11(5), 1104–1111.
2. Abboud G, Midulla M, Lions C, El Ngheoui Z, Gengler L, Martinelli T, Beregi JP. (2010). “Right-sided” May-Thurner syndrome. Cardiovasc Intervent Radiol. 33(5):1056-9.
3. Collum, A. (2021). What is May-Thurner Syndrome. RIA Endovascular Radiology Imaging Associates P.C
4. Harbin, M. M., & Lutsey, P. L. (2020). May-Thurner syndrome: History of understanding and need for defining population prevalence. Journal of thrombosis and haemostasis : JTH, 18(3), 534–542.
5. Moudgill N, Hager E, Gonsalves C, et al. (2009) May-Thurner syndrome: case report and review of the literature involving modern endovascular therapy. Vascular; 17:330.
6. Mangla, A., & Hamad, H. (2022). May-Thurner Syndrome. In StatPearls. StatPearls Publishing.
7. Burke RM, Rayan SS, Kasirajan K, Chaikof EL, Milner R. (2006) Unusual case of right-sided May-Thurner syndrome and review of its management. Vascular.; 14(1):47-50.
8. Abboud G, Midulla M, Lions C, El Ngheoui Z, Gengler L, Martinelli T, Beregi JP. (2010) “Right-sided” May-Thurner syndrome. Cardiovasc Intervent Radiology.; 33(5):1056-9.
9. Andrew R. Forauer, Joseph J. Gemmete, Narasimham L. Dasika, Kyung J. Cho, David M. Williams, (2002) Intravascular Ultrasound in the Diagnosis and Treatment of Iliac Vein Compression (May-Thurner) Syndrome, Journal of Vascular and Interventional Radiology, Volume 13, Issue 5, Pages 523-527, ISSN 1051-0443
10. Negus D, Fletcher EW, Cockett FB, Thomas ML. (1968) Compression and band formation at the mouth of the left common iliac vein. Br J Surg.; (5):369-74.
11. Cockett FB, Thomas ML. (1965) The iliac compression syndrome. Br J Surg.; 52(10):816-21.
12. Kushner A, West WP, Khan Suheb MZ, et al. (2022). Virchow Triad. Stat Pearls
13. BMJ Publishing Group. (2017) Virchow’s Triad of the Three Broad Categories. Research Gate.
14. Birn J, Vedantham S. (2015) May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med; 20:74.
15. Bjordal RI. (1970) Intermittent venous claudication. A report of two cases. Acta Chir Scand; 136:641.
16. Hosn MA, Katragunta N, Kresowik T, Sharp WJ. (2016) May-Thurner syndrome presenting as spontaneous left iliac vein rupture. J Vasc Surg Venous Lymphat Disord; 4:479.
17. Mickley V, Schwagierek R, Rilinger N, et al. (1998) Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg; 28:492.