Emergency Medical Minute1 Helmi 2021

Podcast 636: May-Thurner Syndrome

Contributor: Sam Killian, MD

Educational Pearls:

iliac vein compression syndrome is also called May-Thurner Syndrome
The left leg more frequently develops deep venous thrombosis (DVT) in part because about 1/4 of the population has May-Thurner
May-Thurner syndrome anatomic variant results in a right iliac artery compresses the left iliac vein against the spine, which can promote DVT formation
This is thought to be the cause of 2-3% of DVTs in patients seen in the ED and suspicion for this disease should increased in those with recurrent DVT
Diagnosis is made with MRV/MRA and will typically not be seen on duplex ultrasound
Typical anticoagulation treatment fails to address the underlying structural cause

References

Demir MC, Kucur D, Çakır E, Aksu NM, Onur MR, Sabuncu T, Akkaş M. May-Thurner syndrome: A curious syndrome in the ED. Am J Emerg Med. 2016 Sep;34(9):1920.e1-3. doi: 10.1016/j.ajem.2016.02.045. Epub 2016 Feb 19. PMID: 26971822.

Sharafi S, Farsad K. Variant May-Thurner syndrome: Compression of the left common iliac vein by the ipsilateral internal iliac artery. Radiol Case Rep. 2018;13(2):419-423. Published 2018 Feb 20. doi:10.1016/j.radcr.2018.01.001

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD

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