May-Thurner Syndrome: A Rare, Yet Recognized, Cause of Deep Vein Thrombosis

Area of Science:

• Vascular Surgery
• Cardiology
• Radiology

Background:

• May-Thurner syndrome (MTS) is a vascular condition characterized by the compression of the left common iliac vein (CIV) by the right common iliac artery (CIA).
• This chronic compression can lead to venous stasis and increase the risk of deep vein thrombosis (DVT) in the left lower extremity.
• MTS is often underdiagnosed, particularly in younger individuals presenting with seemingly idiopathic DVT.

Observation:

• A 19-year-old patient presented with severe left-sided DVT, including significant thigh pain, erythema, and ambulation difficulties.
• The patient also experienced pleuritic chest pain, indicative of a pulmonary embolism (PE).
• Diagnostic imaging confirmed severe MTS as the underlying cause of the DVT and subsequent PE.

Findings:

• The patient underwent successful surgical thrombectomy to remove the thrombus from the left CIV.
• Endovascular stenting of the narrowed left CIV was performed to restore venous outflow.
• Post-procedural assessment showed resolution of DVT symptoms and successful management of PE.

Implications:

• This case highlights the importance of considering MTS in young patients with left lower extremity DVT and PE.
• Timely diagnosis and intervention, including surgical and endovascular techniques, can lead to favorable outcomes in severe MTS.
• Effective management of MTS can prevent long-term complications associated with chronic venous obstruction and recurrent thromboembolic events.