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May-Thurner Syndrome (MTS) Overview

May-Thurner Syndrome is a rare anatomic process affecting men and women, often discovered between the ages of 20-45, that causes severe left leg swelling, pain, pressure, and leg heaviness. It can cause complications such as a DVT and Post-Thrombotic Syndrome that are life-limiting to patients. In MTS, the right iliac artery, which carries the blood to your right leg, squeezes the left iliac vein, preventing efficient blood flow. Imagine the vein and artery intersecting and crossing, and that compression prevents the blood from flowing properly.

May-Thurner Syndrome Causes

May-Thurner Syndrome (MTS) occurs when the right common iliac artery compresses the left iliac vein, resulting in a restriction of venous blood flow leaving the lower extremities. This will often cause the patient to feel pain, pressure, heaviness, or experience swelling in the lower legs.

You Have a Choice When It Comes to Vascular Care.
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You Have a Choice When It Comes to Vascular Care.
Get an Appointment at VIC In 3 to 5 Days – Without a Referral!

May-Thurner Syndrome Risk Factors & Symptoms

Risk Factors That May Affect Patients

  • Female
  • Scoliosis
  • Hysterectomy
  • Pelvic Surgery
  • Anterior Spine Surgery
  • Multiple pregnancies
  • Taking oral contraception
  • Dehydration
  • Condition that causes blood clotting
woman with pelvic pain from may-thurner syndrome

Symptoms Include:

  • Pain in the lower abdomen or pelvis area
  • Varicose veins in the upper leg – left side
  • Swelling in the legs, often left side most severe
  • Chronic pain, pressure, & heaviness that worsens as the day goes on
  • Chronic Hemorrhoids

Most importantly, if you are a patient between the ages of 20-45, with any of these signs or symptoms, the first and most important step is to seek help from your medical provider.

May-Thurner Syndrome Diagnosis

Simple non-invasive tests can be performed in our office to diagnose the presence of May-Thurner Snydrome (MTS).  An ultrasound of the pelvis, a CT venogram or an intravascular ultrasound (IVUS) can give the vascular surgeon an understanding as to the severity/complexity of the condition.  In some cases, medical management is effective in the short term to reduce the symptoms and reduce the pain a patient in experiencing.

May-Thurner Syndrome Treatment

Endovascular intervention is a minimally invasive procedure that can be done in an outpatient surgical suite.  The vascular surgeon will use a combination of a stent and the guidance of the IVUS to determine the vein segments that are affected, and the best place to deploy the devices for optimal outcome.  Opening the vein restores normal circulation.

May-Thurner Syndrome Prevention

The following actions can be done to potentially reduce the symptoms of May Thurner Syndrome (MTS). Suggestions for prevention include:

  • Using a compression hose/stocking to control swelling
  • Wearing compression hose/stockings during extended or delayed travel
  • Maintain a healthy weight and commit to exercise daily
  • Walking 5-10 minutes every few hours if you sit or stand for long periods

May-Thurner Syndrome Disease Progression

If left untreated, May-Thurner Syndrome can progress into different stages of disease.

Stage 1: Iliac Vein Compression – some patients may or may not experience symptoms, formation of varicose veins may occur.

Stage 2:  Venous Spur Formation – the vein can develop fibrous type shelves which cause the blood flow to be restricted, increasing the chance for a DVT to occur.

Stage 3:  Deep Vein Thrombosis (DVT) – happens when a blood clot is formed within the vein.  The flow is restricted, leading to severe pain, and swelling in the legs.

FAQs

Yes. Endovascular interventions are available to alleviate the pain and discomfort associated with this condition. Once treatment is administered, recovery is rapid in most patients with a return to normal activities. Follow-up appointments on a regular basis with your provider are advised.

Fatigue can be seen in patients along with other complications such as varicose veins and ulcers. If you experience any symptoms, especially fatigue with walking, make sure to contact your medical provider for evaluation.

Based on the location of the offending vein, lower back pain or lower abdominal pain can be felt in some patients. The severity of pain can be variable and often accompanied by lower leg swelling, pressure, or heaviness.  Seeking medical attention is advised.

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