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Percutaneous treatment of deep vein thrombosis in May-Thurner syndrome

Jong-Youn Kim1, Donghoon Choi, Young Guk Ko

  • 1Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.

Cardiovascular and Interventional Radiology
|February 28, 2006
PubMed

Insights

May-Thurner syndrome, a condition causing deep vein thrombosis, can be effectively treated with endovascular methods. Catheter-guided thrombolysis and stenting offer a safe and successful approach for patients with this venous compression disorder.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • May-Thurner syndrome involves compression of the left common iliac vein by the right common iliac artery.
  • This compression can lead to deep vein thrombosis (DVT) and chronic venous insufficiency.
  • Endovascular techniques are increasingly utilized for managing complex venous pathologies.

Purpose of the Study:

  • To evaluate the efficacy and safety of endovascular treatment for May-Thurner syndrome.
  • To assess outcomes of catheter-guided thrombolysis, angioplasty, and stenting in patients with iliofemoral DVT.
  • To report clinical experience with these minimally invasive interventions.

Main Methods:

  • A cohort of 21 patients diagnosed with May-Thurner syndrome via venogram was studied.
  • Eighteen patients underwent catheter-guided thrombolysis followed by balloon angioplasty and/or stent placement.
  • Three patients with limited venous involvement were treated without thrombolysis.

Main Results:

  • Initial technical success with symptom resolution was achieved in 95% (20/21) of patients.
  • Mean follow-up was 10.8 months; recurrent thrombosis occurred in 2 patients with stents and 3 without.
  • One patient experienced a major bleeding complication (retroperitoneal hematoma); overall safety was high.

Conclusions:

  • Catheter-guided thrombolysis combined with angioplasty and stent implantation is a safe and effective treatment for May-Thurner syndrome.
  • Endovascular management provides high initial success rates for extensive iliofemoral DVT caused by this syndrome.
  • Stenting appears crucial for preventing recurrence in May-Thurner syndrome patients treated endovascularly.
Abstract

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