Podcast 636: May-Thurner Syndrome

<p><strong>Contributor: Sam Killian, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">iliac vein compression syndrome is also called May-Thurner Syndrome</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">The left leg more frequently develops deep venous thrombosis (DVT) in part because about 1/4 of the population has May-Thurner</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">May-Thurner syndrome anatomic variant results in a right iliac artery compresses the left iliac vein against the spine, which can promote DVT formation</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">This is thought to be the cause of 2-3% of DVTs in patients seen in the ED and suspicion for this disease should increased in those with recurrent DVT</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Diagnosis is made with MRV/MRA and will typically not be seen on duplex ultrasound</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Typical anticoagulation treatment fails to address the underlying structural cause</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Demir MC, Kucur D, Çakır E, Aksu NM, Onur MR, Sabuncu T, Akkaş M. May-Thurner syndrome: A curious syndrome in the ED. Am J Emerg Med. 2016 Sep;34(9):1920.e1-3. doi: 10.1016/j.ajem.2016.02.045. Epub 2016 Feb 19. PMID: 26971822.</span></p> <p><span style="font-weight: 400;">Sharafi S, Farsad K. Variant May-Thurner syndrome: Compression of the left common iliac vein by the ipsilateral internal iliac artery. Radiol Case Rep. 2018;13(2):419-423. Published 2018 Feb 20. doi:10.1016/j.radcr.2018.01.001</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD</span></em></p> <p><br /> <br /></p>