scholarly journals Childhood Varicose Veins–An Unusual Visceral “May–Thurner” Like Compression

2021 ◽  
Author(s):  
Sreenivasa Narayana Raju ◽  
Rengarajan Rajagopal ◽  
Niraj Nirmal Pandey ◽  
Amarinder Singh ◽  
Sanjeev Kumar
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Left Kidney ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Left Lower Limb ◽  
Limb Edema ◽  
Lateral Decubitus

AbstractWe report the case of 8-year-old girl with left lower limb edema due to superficial venous incompetence and varicosities. Color Doppler demonstrated compression of the left common iliac vein by an ectopic left kidney, which was partly relieved in right lateral decubitus position. CT demonstrated ectopic malrotated pelvic kidney, compressing the left common iliac vein against the L5 vertebra. A “May–Thurner” like syndrome due to visceral compression needs to be suspected in children with unilateral left lower limb varicosities.

A RARE CASE OF MAY- THURNER SYNDROME

2021 ◽  
pp. 17-19
Author(s):  
B. Santhi ◽  
Manigandan Manigandan ◽  
Nishok Nishok
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Rare Case ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Middle Aged ◽  
Unique Case ◽  
Left Common Iliac Vein ◽  
Left Lower Limb

May-Thurner syndrome (MTS) is a venous outow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic.We report a unique case of a 25 -year-old male who presented with MTS-related multiple varicosities in left lower limb.

scholarly journals May-Thurner Syndrome and Recurrent DVT: A Case Report

2020 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Neha Tarannum ◽  
H.V.V.S.S. Lakshman K. ◽  
Mohammed Sadiq Azam ◽  
Rajendra Kumar Premchand
Keyword(s):  
Lower Limb ◽  
Vena Cava ◽  
Iliac Vein ◽  
Definitive Treatment ◽  
Common Iliac Vein ◽  
Venous Flow ◽  
Left Common Iliac Vein ◽  
Left Lower Limb ◽  
High Index Of Suspicion ◽  
Variable Condition

May-Thurner syndrome/Cockets syndrome/ileocaval syndrome is a rarely diagnosed, anatomical and pathologically variable condition, causing venous flow obstruction in iliocaval territory. We report a case of 64 year old male patient who presented with unprovoked proximal deep venous thrombosis (DVT) of left lower limb. Evaluated for hypercoagulable state, which was negative, the patient underwent catheter guided thrombolysis and anticoagulation for 6 months. Two years later, he developed left lower limb swelling, and venous doppler revealed acute DVT; CT venogram was consistent with left common iliac vein compression by right common iliac artery suggestive of May-Thurner syndrome. Catheter-guided thrombolysis was done, and percutaneous transluminal peripheral angioplasty/stent was placed from inferior vena cava to left common iliac vein. This case highlights the importance of high index of suspicion in managing patients with DVT for possible ileocaval syndrome wherein anticoagulation alone is insufficient and needs more aggressive and definitive treatment to relieve the obstruction and to prevent recurrence.

scholarly journals Recurrent unilateral cellulitis: is it May-Thurner syndrome (MTS)?

2019 ◽  
Vol 12 (7) ◽  
pp. e229511
Author(s):  
Kay Tai Choy ◽  
Sherab Bhutia
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Iliac Artery ◽  
Lower Limb ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Left Lower Limb ◽  
Treatable Condition

May-Thurner syndrome (MTS) is a differential diagnosis to be considered in a patient with recurrent unilateral cellulitis. A 73-year-old woman initially presented with recurrent unilateral cellulitis of her left lower limb. A CT scan demonstrated a stenosed left common iliac vein (CIV) narrowed at its origin by the proximal right common iliac artery consistent with MTS. The chronicity of the condition at the time of diagnosis made attempts to recanalise the CIV unsuccessful. A diagnosis of MTS should be considered in a patient with chronic unilateral limb oedema/cellulitis as it represents a potentially treatable condition if detected early.

scholarly journals A neonate with Klippel–Trénaunay syndrome: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Franck Katembo Sikakulya ◽  
Walufu Ivan Egesa ◽  
Sonye Magugu Kiyaka ◽  
Philip Anyama
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Port Wine ◽  
Black African ◽  
Port Wine Stains ◽  
Left Lower Limb ◽  
Clinical Triad ◽  
Klippel Trenaunay Syndrome

Abstract Background Klippel–Trénaunay syndrome is a rare congenital capillary–lymphatic–venous condition characterized by the clinical triad of capillary malformations (port wine stains), varicose veins with or without venous malformations, and bony and/or soft-tissue hypertrophy. It has a very low incidence of about 1:100,000. Case presentation We report the case of 21-day-old neonate Black African female (born in Uganda) with Klippel–Trénaunay syndrome who presented with macrodactyly and ectrodactyly on the left foot, as well as numerous port wine stains on the left thoracoabdominal region and anteroposterior left lower limb. Color Doppler ultrasound examination of the left lower limb and abdomen revealed varicose veins without signs of arteriovenous fistula. Conclusion The report presents the case of a neonate with a rare congenital vascular disorder type Klippel–Trénaunay syndrome.

scholarly journals May–Thurner syndrome, a diagnosis to consider in young males with no risk factors: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Joel Zhen Khang Hng ◽  
Shu Su ◽  
Noel Atkinson
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Endovascular Treatment ◽  
Computer Tomography ◽  
Lower Limb ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Lower Limb ◽  
Deep Vein

Abstract Background May–Thurner syndrome is an anatomical condition characterized by compression of the left common iliac vein by the right common iliac artery, causing venous outflow obstruction. It is an uncommon cause of deep vein thrombosis and is more prevalent among women. This paper highlights the importance of considering May–Thurner syndrome in young males without risk factors presenting with left lower limb pain, as endovascular treatment may be required. Case presentation A 23 year-old Caucasian male presented with a 1-week history of left lower limb pain, edema, and pallor. He was found to have an unprovoked deep vein thrombosis on Doppler ultrasound involving the left fibular, soleus, gastrocnemius, popliteal, femoral, common femoral, and external iliac veins. A heparin infusion was commenced as the initial treatment for deep vein thrombosis. Further investigation with computer tomography pulmonary angiogram and computer tomography venography of the abdomen and pelvis showed bilateral pulmonary emboli and left common iliac vein compression with left common, internal, and external iliac vein thrombosis. He was diagnosed with May–Thurner syndrome despite having no risk factors. A retrievable Cook Celect Platinum inferior vena cava filter was placed, and thrombus of the left common femoral, external, and common iliac veins was treated successfully with AngioJet thrombectomy, thrombolysis using 200,000 units of urokinase, angioplasty and stenting using two Cook Zilver Vena venous self-expanding stents. Therapeutic enoxaparin was commenced on discharge. His filter was removed after 10 weeks. Hematological follow-up 4 months later showed an overall negative thrombophilia screen, and anticoagulation was switched to apixaban. He has had no recurrent thrombosis. Conclusions Clinicians should have a low threshold to investigate for May-Thurner syndrome in patients with left lower limb venous thrombotic events regardless of risk factors, as endovascular treatment may be required to minimize the long-term sequelae of deep vein thrombosis. Duplex ultrasound can be used initially for diagnosis, and computer tomography venography used subsequently if the common iliac vein is not visualized on ultrasound. Endovascular treatment is preferred over anticoagulation alone, especially in otherwise fit patients presenting early, the aim being to reduce the chances of chronic venous hypertension in the lower limb.

Successful treatment of acquired arteriovenous fistula following iliac vein thrombosis

Vascular ◽  
2021 ◽  
pp. 170853812199529
Author(s):  
Zunxiang Ke ◽  
Qin Li ◽  
Chao Yang
Keyword(s):  
Arteriovenous Fistula ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Endovascular Recanalization ◽  
Left Limb ◽  
Limb Edema ◽  
Fistula Treatment ◽  
Iliac Vein Thrombosis

Objectives Cases of arteriovenous fistula following iliac vein thrombosis are uncommon. The pathogenesis of its formation remains unclear. We present the efficacy of left common iliac vein recanalization in acquired arteriovenous fistula treatment. Methods A 71-year-old man presented with severe lower left limb edema and was diagnosed with acquired arteriovenous fistula following iliac vein thrombosis. Treatment by recanalizing the left common iliac vein with bare stents was selected over embolizing the arteriovenous fistula, leading to an excellent clinical outcome. Results and Conclusions: Acquired arteriovenous fistula should be considered in some patients with post-thrombotic syndrome. Endovascular recanalization without embolization of the arteriovenous fistula can effectively treat iliac vein thrombosis associated with arteriovenous fistula.

scholarly journals A rare case of May-Thurner-like syndrome in an elderly lady

2014 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Kapil Sahnan ◽  
Chris Pui Yan Yee ◽  
Robert Hywel Thomas ◽  
Kaji Sritharan
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Imaging Modality ◽  
Lumbar Vertebrae ◽  
Kidney Injury ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Extrinsic Compression ◽  
Duplex Imaging

An elderly lady presented with decreased mobility, sputum production and intermittent confusion. She was treated for chest sepsis, fast atrial fibrillation, and acute kidney injury, and also noted to have a swollen left leg. Venous duplex imaging showed extensive thrombus within the left common iliac, left external iliac and left common femoral veins. A CT Venogram showed compression of the left common iliac vein between an osteophyte at L5 and a calcified ipsilateral common iliac artery. It also showed a pelvic kidney with an extra renal pelvis and large renal cyst which was indirectly contributing to venous compression by splinting the left iliac artery. A decision was made after discussion at the Vascular MDT that the patient was not fit enough for surgery and to manage her medically with anticoagulation. Discussion: Proximal DVT’s are rarer than distal thrombosis, but have similar causes. One of the rarer causes of proximal DVT is May-Thurner syndrome and its variants known collectively as non-thrombotic iliac vein lesions. May-Thurner originally described DVT formation caused by extrinsic compression of the left common iliac vein between the overriding contralateral (right) common iliac artery and adjacent lumbar vertebrae. The best imaging modality is a CT Venogram. Duplex ultrasonography can be used, although it can be difficult to visualize the iliac veins. The mainstay of management is surgical thrombectomy, or thrombolysis, followed by stenting of the affected vessel. However, if intervention is not appropriate, then it can be managed medically with anticoagulation. 

scholarly journals Percutaneous thrombectomy using a novel single session device for acute iliofemoral deep vein thrombosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 74-77
Author(s):  
Gerard O’Sullivan
Keyword(s):  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Left Thigh ◽  
Common Iliac Vein ◽  
Single Session ◽  
Venous Thrombectomy ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Deep Vein ◽  
Percutaneous Thrombectomy

Summary: A 74-year-old woman presented with acute symptomatic left thigh and calf swelling; imaging demonstrated evidence of occlusive thrombosis from the upper left common iliac vein to the mid-thigh. Single session zero-thrombolysis venous thrombectomy was performed using the ReVeneTM Thrombectomy Catheter.

scholarly journals A Rare Cause of May-Thurner Syndrome Postarterial Intervention

2019 ◽  
Vol 03 (03) ◽  
pp. 180-184 ◽  
Author(s):  
Hiok Yang Chan ◽  
Edward Tieng Chek Choke ◽  
Tjun Yip Tang ◽  
Chandramohan Sivanathan ◽  
Chua Ming Er Jasmine ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Iliac Artery ◽  
Lower Limb ◽  
Unusual Case ◽  
Anatomical Variation ◽  
Iliac Vein ◽  
Team Approach ◽  
Left Lower Limb ◽  
Iliac Vein Compression

AbstractMay-Thurner syndrome (MTS) is rare condition thought to occur due to an anatomical variation. In MTS, there is left iliac vein compression by the right iliac artery and lumbar spine resulting in left lower limb deep venous thrombosis. The authors report a rare cause of MTS postarterial intervention. They describe the unusual case of an Asian man who presented with acute left lower limb deep venous thrombosis 5 days following left common iliac artery angioplasty and stent insertion. Computed tomographic (CT) venogram demonstrated the left iliac vein compression by the left iliac artery stent. Successful recanalization of the thrombosed iliac vein was achieved with a combination of pulse spray thrombolysis and rheolytic mechanical thrombectomy, followed by angioplasty and stent placement in the iliac vein. There was rapid and complete resolution of symptoms. This report illustrates the use of complementary imaging modalities and a multidisciplinary team approach to achieve a successful technical and clinical outcome following an unusual case of MTS postarterial intervention and the subsequent successful endovascular management.

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