May-Thurner Syndrome (MTS) is the compression of the left common iliac vein by the right common iliac artery against the lumbar vertebrae. When no symptoms are present, it is called May-Thurner phenomenon; when symptoms appear, it is known as the syndrome. This condition is part of the obstructive venous diseases, such as Nutcracker Syndrome.
Partial obstruction can be mild and remain asymptomatic, whereas more severe obstruction can cause thrombosis with significant symptoms.
May-Thurner Syndrome is a lesser-known condition, but it is a recognized, important cause of proximal deep vein thrombosis.
Risk Factors for May-Thurner Syndrome
Risk factors include: female sex, postpartum status, multiparity (having had multiple births), oral contraceptive use, or spinal abnormalities. Dehydration and procoagulant states strongly influence cases of MTS and thrombosis.
Symptoms of May-Thurner Syndrome
Symptoms range from mild, occasional swelling of the left lower limb to severe, painful, and debilitating edema. Other symptoms may resemble those of chronic venous insufficiency: varicose veins, swelling, pain, itching, skin discoloration, and more.
The typical presentation is a young woman experiencing sudden swelling across the entire left lower extremity.
Diagnosing May-Thurner Syndrome
In addition to clinical suspicion, diagnosis is carried out using venous Doppler ultrasound or CT angiography, and is confirmed with a venogram—during which both the thrombosis and the stenosis can be treated.
Treatment for May-Thurner Syndrome
Asymptomatic patients or those with mild symptoms are not treated surgically.
Intravascular ultrasound (IVUS) is used for a more precise diagnosis. When clots are present, thrombectomy or aspiration devices are used to break down or remove them, and stents are placed to relieve the extrinsic compression.
In addition to symptom relief, the main goal of treatment is to prevent post-thrombotic syndrome—a condition that can severely impact long-term quality of life.
At the Vascular, Arterial, and Venous Disease Area at Centro Médico ABC, we provide specialized care. Contact us today!
