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Iatrogenic May-Thurner syndrome after EVAR
Amrita S Pandit1, Maura Hayes1, Sheila Guiney-Borgelt1
1Danbury Hospital, Danbury, Connecticut.
Annals of Vascular Surgery
|February 25, 2014
Summary
May-Thurner syndrome (MTS) can occur after aortic aneurysm repair. Early diagnosis of this iliac vein compression syndrome is crucial for patients experiencing leg swelling post-EVAR.
Area of Science:
- Vascular Surgery
- Radiology
- Venous Disease
Background:
- May-Thurner syndrome (MTS) involves left iliac vein compression, leading to venous stasis and potential deep vein thrombosis.
- This condition typically arises from anatomical variations but can be iatrogenically induced.
Observation:
- A case of MTS developed after endovascular aneurysm repair (EVAR) involving aortic stent graft placement.
- The patient presented with new-onset unilateral limb swelling, a key indicator of venous compromise.
Findings:
- The aortic stent graft placement contributed to the development of MTS in this patient.
- Chronic pulsatile compression from the iliac artery caused intimal hyperplasia of the left iliac vein.
Implications:
- Increased clinical suspicion for MTS is warranted in patients with unilateral leg swelling post-EVAR.
- Comprehensive venous duplex ultrasound, including suprainguinal assessment, is recommended for diagnosing MTS in this population.
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