May Thurner Syndrome
May Thurner Syndrome or Iliac Vein Compression Syndrome is a syndrome that occurs as a result of the right iliac artery, that is, the artery, pressing on the left iliac vein, that is, the vein. This syndrome can cause swelling in the left leg and an increased risk of Deep Vein Thrombosis (DVT). Blood clots that form as a result of Deep Vein Thrombosis interfere with blood flow, and many patients with May Thurner Syndrome do not complain until they develop a DVT. The importance of May Thurner Syndrome is that it causes DVT to develop and this thrombosis causes life-threatening pulmonary embolism, that is, clotting to the lung.
Usually does not complain. Therefore, although there is no definite information about its prevalence, it was claimed that 10% of the population is present in a study conducted in 2016. The importance of this is the risk of developing DVT, and May Thurner Syndrome is held responsible for 2-3% of lower extremity, that is, leg DVTs.
MAY THURNER SYNDROME RISK FACTORS
May Thurner syndrome is often seen in women between the ages of 20-40. As a result of pregnancy and long-term inactivity, the possibility of developing this syndrome increases. Depending on the decrease in blood flow, pain, swelling and ulcers, ie wounds, may occur in the leg in later periods. Unfortunately, May Thurner Syndrome has no warning signs or symptoms. The risk factors are also the same as the general DVT risk factor:
- Recent major surgery or accident
- Coagulation disorders,
- Prolonged inactivity
- Smoking
- Prolonged severe venous insufficiency (internal varicose veins)
- Cancer
- Obesity
- Pregnancy
- Advanced age
HOW IS MAY THURNER SYNDROME DIAGNOSED?
It is very difficult to diagnose May Thurner Syndrome because there are no obvious signs or symptoms. These patients often present to the doctor with a Deep Vein Thrombosis and present with their classic symptoms:
- Swelling in the legs
- Increased temperature in the affected area
- Skin rash
- Pain
- Sensibility
If you have complaints such as shortness of breath, chest pain, cough, there is a possibility that the clot that has developed in the leg has spread to the lungs, that is, there is a possibility of pulmonary embolism. You need to see a doctor urgently. If in doubt, your doctor will ask you for further examination. This can usually be simple doppler ultrasonography or tomography, MR or venography, i.e. medicated film.
TREATMENT OF MAY TURNER SYNDROME
May Thurner syndrome, treatment depends on your symptoms and how serious they are. If you have severe symptoms, treatment will typically be to restore the left iliac vein flow, the symptoms will subside, and our risk of Deep Vein Thrombosis will be eliminated.
Treatment alternatives:
*Angioplasty and stent: In this procedure, which will be performed in the angioplasty laboratory, it is possible to place a stent in the narrowed area, even if the vessel needs to be expanded with a balloon.
*Bypass surgery: In bypass surgery, which will be performed as open surgery, a vessel will be placed so that the narrowed area is bypassed.
*Reposition: In reposition surgery, which is an open surgery, the pressure on the vein will be removed by changing the places of the artery and vein.
If Deep Vein Thrombosis has developed, your doctor will consider blood thinners, anticoagulants and other drug treatments suitable for you in addition to emergency treatment.
LIVING WITH MAY THURNER SYNDROME
Under normal conditions, May Thurner Syndrome does not have any complaints related to its own pathology, so many patients live their lives without even being diagnosed. Since the most important symptom of this syndrome is Deep Vein Thrombosis, which can be life-threatening, the majority of patients present with DVT complaints and while the cause is being investigated, May Thurner Syndrome is usually detected and directed to treatment. In other words, if you have not had a DVT attack in any period, this will only be found by an accidental abdominal ultrasonography or abdominal film. Otherwise, you will continue your normal life.
