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

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• May-Thurner syndrome (MTS) involves left common iliac vein compression by the right common iliac artery, leading to venous outflow obstruction.
• MTS commonly affects young to middle-aged women and can lead to deep vein thrombosis (DVT), though many remain asymptomatic.
• Standard treatment for MTS-related DVT includes endovascular procedures like thrombolysis, angioplasty, and stenting.

Observation:

• A 31-year-old woman presented with MTS-related DVT and symptomatic abdominal and pelvic varicosities, an uncommon manifestation.
• The patient's varicosities were successfully treated using a multimodal endovascular approach.
• Complete resolution of all symptoms was achieved post-intervention.

Findings:

• This case demonstrates successful management of an unusual presentation of MTS-related post-thrombotic syndrome.
• The treatment involved addressing both the DVT and the complex pelvic varicosities.
• Successful endovascular intervention led to symptomatic relief and resolution of varicosities.

Implications:

• This case expands the understanding of MTS complications and their management.
• It highlights the efficacy of endovascular techniques in treating complex venous disorders.
• The findings suggest a tailored endovascular approach can effectively manage symptomatic varicosities secondary to MTS.