May-Thurner Syndrome with Double Compression of the Iliac Vein: Lessons Based on a Case Report

Area of Science:

• Vascular Surgery
• Radiology
• Medical Imaging

Background:

• May-Thurner syndrome (MTS), or Cockett's syndrome, is a condition where the left iliac vein is compressed, typically by the right iliac artery.
• This compression leads to venous stenosis and can cause symptoms like lower limb swelling and pain.
• Doppler ultrasound is a primary diagnostic tool for evaluating vascular pathologies like MTS.

Observation:

• A 73-year-old woman presented with acute dyspnea and left lower limb lymphedema.
• Imaging revealed an unusual case of double stenosis in the left common iliac vein.
• The stenosis was caused by compression from both the right and left iliac arteries, exacerbated by vertebral osteophytosis.

Findings:

• Doppler ultrasound accurately identified the double stenosis of the left common iliac vein.
• Computed tomography provided detailed anatomical information on the vascular compression.
• The findings underscore the importance of considering MTS in patients with left leg venous stasis symptoms.

Implications:

• Early diagnosis of May-Thurner syndrome is crucial to prevent severe health risks.
• Doppler ultrasound is effective in detecting iliac vein stenosis and associated flow abnormalities.
• This case emphasizes the need for high clinical suspicion for MTS, even in atypical presentations.