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May-Thurner syndrome is caused by the compression of the left common iliac vein by the right common iliac artery, leading to leg pain and swelling. Women aged 20-50 are more likely to develop it. Diagnosis involves a venogram, and treatment includes managing any associated DVT and widening the narrowed vein through angioplasty or other surgical procedures. Early treatment is important for a positive outlook.
May-Thurner syndrome, or STD, is an iliac vein compression syndrome. This is where the left common iliac vein, which carries blood from the left leg, is pressed by the right common iliac artery, which supplies blood to the right leg. The pressure occurs at a point where the artery crosses the vein and causes the vein to be pressed against the bones of the spine. Scarring and narrowing of the vein occurs, and symptoms of leg pain and leg swelling may occur. Sometimes people with May-Thurner syndrome can develop blood clots in their veins, a condition known as deep vein thrombosis or DVT.
Women between the ages of 20 and 50 are more likely to develop May-Thurner syndrome. In mild cases, there may be no symptoms. As the condition progresses, the left leg may swell permanently. If you have a DVT, your leg may also hurt, appear red and feel warm, and veins may appear more prominent than usual. It is important to treat DVT, because it can lead to a life-threatening pulmonary embolism, in which the clot breaks loose and blocks the blood supply to the lungs.
Diagnosing May-Thurner syndrome generally involves doing what is known as a venogram. A special dye, visible on X-rays, is injected into a vein in the foot and travels to the common iliac vein, where it shows blood flow through the vein. The pressure of the blood flowing to each side of the narrow section can be measured to gauge the severity of the blockage.
Management of May-Thurner syndrome generally involves treating any associated DVT and widening the narrowed vein. Medicines to break up a blood clot can be given directly to it through a narrow tube inserted into a vein. Once any clot has been addressed, a surgical procedure known as an angioplasty may be performed. This involves stretching the narrowed vein by inflating a special type of balloon inside it. A mesh tube can then be inserted and left inside the vein to keep it open permanently.
Other possible treatments include bypassing the blocked vein or moving the right iliac artery so that it no longer causes compression. Sometimes the artery is held away from the vein using a type of sling made from body tissue. The outlook for someone with May-Thurner syndrome is generally positive if treatment is started early, before or just after a clot forms.
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