What is May-Thurner Syndrome?
May-Thurner Syndrome (MTS), sometimes called Iliac Vein Compression Syndrome, primarily affects women between the ages of 20 and 50.
Women diagnosed with MTS will have compression of the left iliac vein leading to a decrease in drainage of the left leg. If left untreated, this may lead to the formation of a deep vein thrombosis (blood clot). This would restrict blood flow, which in turn causes pain, swelling and often times varicose veins in the left leg.
May -Thurner Syndrome presents on the left side, though cases where the right side is affected have been reported.
The name May-Thurner Syndrome comes from the two physicians (May and Thurner) who are credited with first describing the condition in the late 1950s.
What Causes May-Thurner Syndrome?
May-Thurner Syndrome (MTS), also called Iliac Vein Compression Syndrome, occurs when the right common iliac artery compresses the left common iliac vein, restricting the drainage of blood from the lower extremities. MTS is most common in women who have been pregnant and rarely occurs in women who have not had children.
When left untreated, May-Thurner Syndrome may progress through three stages:
- Stage 1: Iliac vein compression, which often causes no symptoms.
- Stage 2: Venous spur formation which are fibrous shelves eventually developing in the vein, restricting blood flow and increasing disposition for deep vein thrombosis (DVT).
- Stage 3: Deep vein thrombosis (DVT) formation is when a clot is formed in the vein and blood flow is severely restricted, leading to pain and swelling in the legs and the formation of varicose veins.
Symptoms of May-Thurner Syndrome
Patients with mild narrowing of the vein will often experience no symptoms. As May-Thurner progresses, the following symptoms are common:
- Generalized pain in the lower abdomen and pelvis
- Varicose veins in the upper leg (usually left leg)
- Swelling in the leg (usually left leg)
- Chronic pain in the legs that worsens as the day goes on
Diagnosis of May-Thurner Syndrome
Patients generally come to Center for Vascular Medicine for the diagnosis of May-Thurner Syndrome after experiencing symptoms for several months to years. Often times, they are referred by their OB/GYN or primary care physician. If left untreated, May-Thurner Syndrome may develop into a Deep Vein Thrombosis (blood clot).
We use a number of non-invasive and minimally invasive tests which are generally performed in the outpatient setting. These may include:
- Pelvic ultrasound
- CT venography
- Intravascular ultrasound (IVUS) with venography
Treatment for May-Thurner Syndrome (MTS)
Treatment for MTS varies based on the patient’s specific condition. At Center for Vascular Medicine, we strive to provide the most conservative treatments that will deliver long lasting relief. Most treatments are minimally invasive and are performed in the outpatient setting.
Venoplasty and Stenting
A majority of women diagnosed with May-Thurner Syndrome will undergo a minimally invasive procedure to place a stent in the compressed iliac vein. Using intravascular ultrasound (IVUS), the physician will guide a catheter through the vein in the leg and into the pelvic region allowing precise measurement. If necessary, a balloon and stent may be placed into the vein to keep the vein open.
In a limited number of cases, bypass surgery will be recommended to restore proper blood flow in the pelvic region and lower extremities.