CLINICAL CASE OF ENDOVASCULAR TREATMENT OF A PATIENT WITH MAY-TURNER SYNDROME
https://doi.org/10.17238/issn2072-3180.2021.1.101-105
Abstract
May-Thurner syndrome (CMT) is a disease characterized by compression of the left common iliac vein of the small pelvis by the right iliac artery. Clinically manifested by persistent pelvic pain as well as pain in the left lower extremity. One of the most common symptoms of this syndrome which should be considered is an edema of the left lower limb. The peculiarity of this disease is that the clinical picture is not always specific and is often masked by venous insufficiency of the lower extremities. Therefore, it is important to determine the main cause of the disease and conduct the entire complex of the necessary additional examination. Traditional open surgical interventions in this direction are practically not used today due to their trauma and long rehabilitation period, giving way to a safer and more effective method of treating the compression of the iliac veins - endovascular venous stenting. The first successful stenting of the iliac vein was performed back in 1995. Thus, the tactics of treating May-Turner syndrome have evolved and today, endovascular treatment is preferred as the main method of treatment. Thanks to venous angioplasty and stenting, it is possible to achieve the required clinical result in a low-traumatic and fast manner.
About the Authors
I. P. ParfenovRussian Federation
Parfenov Igor Pavlovich MD, Professor, Chief physician
127644, Moscow, st. Lobnenskaya, 10
M. V. Strutsenko
Russian Federation
Strutsenko Mikhail Valerievich MD, PhD in Medicine, Associate Professor, chief of endovascular department
127644, Moscow, st. Lobnenskaya, 10
M. S. Bagiryan
Russian Federation
Bagiryan Mikhail Semenovich - chief of flebological department
127644, Moscow, st. Lobnenskaya, 10
S. A. Abugov
Russian Federation
Abugov Sergey Alexandrovich – MD, Professor, head of the Department of X-ray Surgery, chief of endovascular university
119991, Moscow, Abrikosovsky lane, 2
125993, Moscow, st. Barrikadnaya, 2/1
V. S. Fomin
Russian Federation
Fomin Vladimir Sergeevich - MD, PhD in Medicine, Associate Professor, surgeon
127644, Moscow, st. Lobnenskaya, 10
References
1. May R., Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology, 1957, 8, рр. 419–427. https://doi.org/10.1177/000331975700800505
2. Berger A., Jaffe J.W., York T.N. Iliac compression syndrome treated with stent placement. J. Vasc. Surg., 1995, 21, рр. 510–414. https://doi.org/10.1016/S0741-5214(95)70295-4
3. Oguzkurt L., Ozkan U., Tercan F. et al. Ultrasonographic diagnosis of iliac vein compression (May–Thurner) syndrome. Diagn. Interv. Radiol., 2007, 13, рр. 152–155.
4. Kibbe M.R., Ujiki M., Goodwin A.L. et al. Iliac vein compression in an asymptomatic patient population. J. Vasc. Surg., 2004, 39, рр. 937–943. https://doi.org/10.1016/j.jvs.2003.12.032
5. Raju S., Neglen P. High prevalence of nonthrombotic iliac vein lesions in chronic venous disease: a permissive role in pathogenicity. J. Vasc. Surg., 2006, 44, рр. 136–143, discussion 144. https://doi.org/10.1016/j.jvs.2006.02.065
6. Ibrahim W., Al. Safran Z., Hasan H. et al. Endovascular management of may-thurner syndrome. Ann. Vasc. Dis., 2012, 5, рр. 217–221.
7. Raju S. Treatment of iliac-caval outflow obstruction. Semin. Vasc. Surg., 2015, 28, рр. 47–53. https://doi.org/10.1053/j.semvascsurg.2015.07.001
8. Brinegar K.N., Sheth R.A., Khademhosseini A. et al. Iliac vein compression syndrome: Clinical, imaging and pathologic findings. World J Radiol ., 2015, 7, рр. 375–381. https://doi.org/10.4329/wjr.v7.i11.375
9. Hager E.S., Yuo T., Tahara R. et al. Outcomes of endovascular intervention for May–Thurner syndrome. J. Vasc. Surg. Venous Lymphat. Disord., 2013, 1, 270–275. https://doi.org/10.1016/j.jvsv.2012.11.002
10. Patel N.H., Stookey K.R., Ketcham D.B. et al. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May–Thurner syndrome. J. Vasc. Interv. Radiol., 2000, 11, рр. 1297–1302. https://doi.org/10.1016/S1051-0443(07)61304-9
11. Metzger P.B., Rossi F.H., Kambara A.M. et al. Criteria for detecting significant chronic iliac venous obstructions with duplex ultrasound. J. Vasc. Surg. Venous Lymphat., 2016, 4 (1), рр. 18–27.
12. M-Grace Knuttinen, Sailendra Naidu, Rahmi Oklu, Scott Kriegshauser, William Eversman, Lisa Rotellini, Patricia E. Thorpe. May–Thurner: diagnosis and endovascular management. Cardiovascular Diagnosis and Therapy, 2017, 7 (Suppl. 3), рр. 159–164. https://doi.org/10.21037/cdt.2017.10.14
13. Baron H.C., Shams J., Wayne M. Iliac vein compression syndrome: a new method of treatment. Am. Surg., 2000, 66 (7), рр. 653–655.
14. Bozkaya H., Cinar C., Ertugay S. Endovascular Treatment of Iliac Vein Compression (May–Thurner) Syndrome: Angioplasty and Stenting with or without Manual Aspiration Thrombectomy and Catheter-Directed Thrombolysis. Ann. Vasc. Dis., 2015, 8 (1), рр. 21–28.
15. Zhukov O.B., Ukolov V.A., Snitkin V.M., Babushkina E.V., Evdokimov V.V. Sindrom Meya–Ternera u muzhchin [May-Turner syndrome in men]. Angiologiya i genital’naya khirurgiya, 2017, Vol. 18, pp. 39–47
Review
For citations:
Parfenov I.P., Strutsenko M.V., Bagiryan M.S., Abugov S.A., Fomin V.S. CLINICAL CASE OF ENDOVASCULAR TREATMENT OF A PATIENT WITH MAY-TURNER SYNDROME. Moscow Surgical Journal. 2021;(1):101-105. (In Russ.) https://doi.org/10.17238/issn2072-3180.2021.1.101-105