scholarly journals May-Thurner syndrome: modern methods of diagnosis and treatment

2021 ◽  
Vol 10 (1) ◽  
pp. 89-96
Author(s):  
D. G. Gitelson ◽  
A. G. Faibushevich ◽  
D. A. Maximkin ◽  
G. I. Veretnik ◽  
V. Yu. Baranovich ◽  
...  
Keyword(s):  
Turner Syndrome ◽  
Intravascular Ultrasound ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Iliac Vein ◽  
Diagnosis And Treatment ◽  
Common Iliac Vein ◽  
Promising Alternative ◽  
Left Common Iliac Vein ◽  
Modern Methods

May-Turner syndrome is a condition where the left common iliac vein is compressed between the lumbar spine and the overlying right common iliac artery. Left iliac vein compression is common (up to 24%) in the general population, but clinical manifestations occur in a few patients. This syndrome should be considered in case of unexplained edema of the left lower extremity since routine duplex ultrasound does not possess optimal sensitivity and specificity in the study of the iliac veins and the inferior vena cava. Intravascular ultrasound is the most accurate diagnostic method. However, the advent of computed tomography angiography and magnetic resonance angiography providing high-quality images of the vasculature have become a promising alternative to invasive intravascular ultrasound. Treatment for May-Turner syndrome usually involves stenting of the left common iliac vein along with medical therapy, including antithrombotic (anticoagulant and antiplatelet) therapy combined with phlebotonics. Our review reports modern methods of diagnosis and treatment of May-Turner syndrome.

scholarly journals May-Thurner Syndrome with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Lori Jia ◽  
Jason Alexander ◽  
Nedaa Skeik
Keyword(s):  
Vena Cava ◽  
Iliac Vein ◽  
Postthrombotic Syndrome ◽  
Common Iliac Vein ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Venous Outflow Obstruction ◽  
Angioplasty And Stenting ◽  
Deep Vein

May-Thurner syndrome (MTS) is a venous outflow 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. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.

Unusual Case of Right-Sided May-Thurner Syndrome and Review of Its Management

Vascular ◽  
2006 ◽  
Vol 14 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Renee M. Burke ◽  
Sunil S. Rayan ◽  
Karthikeshwar Kasirajan ◽  
Elliot L. Chaikof ◽  
Ross Milner
Keyword(s):  
Inferior Vena Cava ◽  
Iliac Artery ◽  
Unusual Case ◽  
Inferior Vena ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Endoluminal Stent

May-Thurner syndrome is a phenomenon commonly described as an acquired stenosis of the left common iliac vein as a result of right common iliac artery compression. We report an unusual case of right-sided May-Thurner syndrome in a patient found to have a left-sided inferior vena cava. We also review the management of this patient using angioplasty, intraoperative thrombolysis, and endoluminal stent placement.

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.

Clinical correlation of the area of inferior vena cava, iliac and femoral veins for stent use

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Afsha Aurshina ◽  
Arkady Ganelin ◽  
Anil Hingorani ◽  
Sheila Blumberg ◽  
Yuriy Ostrozhynskyy ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Intravascular Ultrasound ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Lower Extremities ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Presenting Symptoms ◽  
Significant Difference

Objective The purpose of the study is to evaluate normal anatomical areas of infrarenal inferior vena cava, common iliac, external iliac and common femoral veins by intravascular ultrasound with the goal of assisting the development of venous-specific stents in the treatment of iliac vein stenosis. Method From February 2012 to December 2013, 656 office-based venograms were performed in our facility. Among them, 576 were stented and 80 were not. The measurements of veins were done intraoperatively using an intravascular ultrasound catheter to record areas of the inferior vena cava, proximal, middle and distal segments of common iliac vein, external iliac vein and common femoral vein. The data were compared between non-diseased segments of patients who were stented and those not stented. The stented diseased segments were excluded. Results The mean patient age was 67.33 years (range 22–96, SD ±13.99). Our data included 218 males, 438 females and 324 right lower extremities and 332 left lower extremities. The presenting symptoms of these patients based on CEAP were C1(0), C2 (185), C3(233), C4(107), C5(89) and C6(42). No correlation was found between area of veins and age, gender, laterality and CEAP score (P > .13). Comparison of the areas of non-diseased iliac vein segments between patients not stented and patients who underwent stenting showed a significant difference, with larger areas in non-stented patients in the distal common iliac vein (P = .039) and inferior vena cava (P = .012). Younger age (P = .03) and male gender (P < .0001) were associated with increased area of iliac vein segments. Conclusion Utilizing the intravascular ultrasound-guided technique, we were able to define normal anatomical areas of non-diseased inferior vena cava, iliac and femoral veins, which could be employed to guide the development of appropriate-sized stents and other tools needed for the treatment of venous insufficiency. There is specific variability in areas of normal vein segments with age and gender with/without stents.

scholarly journals ​Venous anomalies in renal transplantation: an accessory left-sided IVC in a live kidney donor

2019 ◽  
Vol 12 (12) ◽  
pp. e232695
Author(s):  
Jack Whooley ◽  
Atakelet Ferede ◽  
Gordon Smyth ◽  
Dilly Little
Keyword(s):  
Rare Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vascular Anomaly ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Kidney Donor ◽  
Left Common Iliac Vein ◽  
Live Kidney Donor ◽  
The Right

Duplication of the inferior vena cava (IVC) resulting in an accessory left-sided IVC is a relatively rare vascular anomaly with a reported prevalence of 0.7%. Radiologically, a duplicated left-sided IVC is usually seen as a continuation of the left common iliac vein, crossing anterior to the aorta at the level of the renal vein to join the right-sided IVC. We present a rare case in which an accessory left-sided IVC was discovered intraoperatively, in a 47-year-old living donor, posing significant intraoperative challenges regarding extraction and subsequent transplantation.

scholarly journals A RARE CASE OF SPONTANEOUS RUPTURE OF THE LEFT COMMON ILIAC VEIN WHICH WAS THE LATE COMPLICATION OF CAVA FILTER INSTALLATION

2020 ◽  
Vol 5 (4) ◽  
pp. 39-43
Author(s):  
Yu. V. Chumakova ◽  
V. A. Tereshchenkov ◽  
M. A. Kislov ◽  
Е. V. Bulanova
Keyword(s):  
Spontaneous Rupture ◽  
Rare Case ◽  
Late Complication ◽  
Muscle Tension ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Anatomical Location ◽  
Filter Placement ◽  
Left Common Iliac Vein

The article is dedicated to a rare case of spontaneous rupture of the pathologically altered left common iliac vein which was a late complication of the cava filter placement. To date this complication has not been described in the national medical literature. In foreign literature only 21 cases of spontaneous rupture of the iliac vein with unclear cause were registered. The article presents a case observed in the practice of the Bureau of forensic medical examination of the Moscow region. It was found that on he background of a number of conditions (occlusion of the inferior vena cava; pathological changes in the venous wall, taking into account its anatomical location; immobilized state of the patient; lack of adequate anticoagulant therapy; predisposing factors in the form of muscle tension) spontaneous rupture of the left common iliac vein should be considered as one of the late cava filter placement complications.Conclusion. Thus, the authors of the article have established the causes of spontaneous rupture of the iliac vein, as well as proposed the inclusion of this pathology in the official list of the late cava filter placement complications. 

Unusual Case of Parkes Weber Syndrome with Aneurysm of the Left Common Iliac Vein and Thrombus in Inferior Vena Cava

2015 ◽  
Vol 29 (7) ◽  
pp. 1450.e17-1450.e19 ◽  
Author(s):  
Igor Banzic ◽  
Milos Brankovic ◽  
Igor Koncar ◽  
Nikola Ilic ◽  
Lazar Davidovic
Keyword(s):  
Inferior Vena Cava ◽  
Unusual Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Weber Syndrome

Selection of retroperitoneal access during intervertebral disc endoprosthesis in lumbar spine

2021 ◽  
Vol 23 (1) ◽  
pp. 73-80
Author(s):  
Maxim A. Priymak ◽  
Ivan A. Kruglov ◽  
Alexei I. Gaivoronski ◽  
Maksim N. Kravtsov ◽  
Gennady G. Bulyshchenko
Keyword(s):  
Lumbar Spine ◽  
Inferior Vena Cava ◽  
Intervertebral Disc ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Intervertebral Discs ◽  
Skin Incision ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein

The morphometric parameters and surgical areas of risk of retroperitoneal approach were studied for endoprosthetics of intervertebral discs in the lumbar spine to reduce trauma and reduce the risk of complications. The study included 110 patients operated on in the period from 2017 to 2020 (72 men, 38 women) in the neurosurgical department of the 1586 Military Clinical Hospital. The average age of the patients was 44.9 15.4 years. According to the localization of access to the lumbar spine, the patients were distributed as follows: LIIILIV 8 (7.3%), LIVLV 46 (41.7%), LVSI 56 (51%). It was found that, for the intervertebral disc LV SI, the length of the skin incision was 92.5 (80; 100) mm, the length of the surgical wound was 80 (80; 110) mm, the thickness of the subcutaneous fat layer was 30 (15; 40) mm, the depth of the wound was to the spine 85 (70; 120) mm, the depth of the wound to the spinal canal 125 (107.5; 152.5) mm, the angle of operation in the horizontal plane at the level of the spine 52 (47; 59.5) degrees. On the basis of the anthropometric data of patients, the optimal length of the skin incision was determined for performing the retroperitoneal approach (120 mm for level LIIILIV, 100 mm for level LIVLV). Three variants of the inferior vena cava bifurcation have been identified for different levels of intervertebral discs in the lumbar spine: high bifurcation, left common iliac vein mainly overlaps the left half of the LIVLV intervertebral disc and does not overlap the LVSI intervertebral disc; middle bifurcation, left common iliac vein overlaps the central part of the intervertebral discs LIVLV and LVSI; low bifurcation, inferior vena cava overlaps the right side of the intervertebral disc LIVLV, inferior vena cava and left common iliac vein completely overlap the intervertebral disc LVSI. The data obtained can be used when planning retroperitoneal access to the lumbar spine in order to reduce the trauma of the operation.

scholarly journals ANOMALOUS COMMUNICATION BETWEEN RIGHT INTERNAL ILIAC VEIN AND LEFT COMMON ILIAC VEIN - A CASE REPORT

2014 ◽  
Vol 04 (03) ◽  
pp. 119-120
Author(s):  
Huban Thomas R. ◽  
Prakashbabu B. ◽  
Radhakrishnan P.
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lumbar Vertebra ◽  
Iliac Vein ◽  
The Body ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac

AbstractInferior vena cava (IVC) is formed by the union of the common iliac veins anterior to the body of the fifth lumbar vertebra, a little to its right side. It conveys blood to the right atrium from all the structures below the diaphragm. During routine educational dissection for medical undergraduates, we have come across a case of an anomalous communication between right internal iliac vein and left common iliac vein and a variation in the formation of inferior vena cava in a 55-year-old male cadaver. Due to its complex embryogenesis and relationship with other abdominal and thoracic structures, IVC may develop abnormally. These anatomical variations are often clinically silent and discovered incidentally. Knowledge of these variations may be helpful to clinicians and anatomists during surgical exploration, atypical clinical presentations and cadaveric findings.

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