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May-Thurner Syndrome

Yub Raj Sedhai1, Reshma Golamari1, Aliaksei Salei2

  • 1Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania.

The American Journal of the Medical Sciences
|May 14, 2018
PubMed

Insights

Endovascular therapy, including thrombolysis and stenting, effectively treated May-Thurner syndrome in this small cohort. While generally safe, one patient with thrombophilia experienced stent thrombosis, indicating a need for further study in this subgroup.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • May-Thurner syndrome (MTS) is an anatomical defect leading to venous compression and thrombosis.
  • Deep vein thrombosis (DVT) and pulmonary embolism (PE) are common clinical presentations of MTS.
  • Endovascular techniques offer a minimally invasive treatment option for MTS.

Purpose of the Study:

  • To evaluate the safety and efficacy of endovascular therapy for May-Thurner syndrome.
  • To assess outcomes in a cohort of adult patients treated for MTS.
  • To identify potential risk factors for treatment failure.

Main Methods:

  • Retrospective review of 6 patients treated for MTS between June 2013 and September 2015.
  • All patients underwent catheter-directed thrombolysis and venous stenting.
  • Clinical presentations, hypercoagulability workup, and follow-up outcomes were analyzed.

Main Results:

  • Endovascular therapy was performed in 6 female patients with MTS, presenting with DVT and/or PE.
  • No major periprocedural complications were observed.
  • One patient with antiphospholipid antibody syndrome developed stent thrombosis and loss of patency during follow-up.

Conclusions:

  • Endovascular therapy appears to be a safe and effective treatment for May-Thurner syndrome in adults.
  • Patients with underlying thrombophilia may be at higher risk for secondary loss of stent patency.
  • Further investigation is warranted for managing MTS in patients with pre-existing hypercoagulable states.

Keywords:
Deep vein thrombosisMay-Thurner syndromePharmaco-mechanical thrombolysisPulmonary embolism and endovascular treatment

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