May-Thurner Syndrome: Causes, Symptoms, Treatment, Prognosis
What is May-Thurner Syndrome?
May-Thurner Syndrome which is also known by the name of Iliocaval Compression Syndrome or Cockett syndrome is a pathological condition that results due to compression of the left iliac vein by the right iliac artery. As a result of this, the patient is at an increased risk for developing Deep Venous Thrombosis or DVT of the left extremity.
What are the Causes of May-Thurner Syndrome?
The main cause of May-Thurner Syndrome is compression of the left iliac vein by the right common iliac artery which runs through the right leg and compresses the vein against the spine. This causes the left iliac vein to get stenosed and scarred resulting in creating an environment where clotting can take place easily and the patient can develop Deep Venous Thrombosis.
What are the Symptoms of May-Thurner Syndrome?
In most of the case of May-Thurner Syndrome, the patient may be completely asymptomatic even though the amount of stenosis of the vein may be mild to moderate. However, in cases of severe narrowing of the vein due to May-Thurner Syndrome the patient may experience the following symptoms:
- Swelling in the legs accompanied by pain
- Development of blood clots
- Development of DVT.
How is May-Thurner Syndrome Diagnosed?
Some of the tests done for diagnosing May-Thurner Syndrome are:
The above three tests are good enough to confirmatively diagnose May-Thurner Syndrome.
How is May-Thurner Syndrome Treated?
The main aim of treatment of May-Thurner Syndrome is to reduce the chances of complications and to reduce the symptoms of May-Thurner Syndrome. Once May-Thurner Syndrome is confirmatively diagnosed the treating physician will formulate the best treatment plan for the patient. The physician may list out potential treatment options for the patient with their risks and benefits. The patient has to weigh the risks versus benefits of each treatment option before going in for a treatment.
The majority of the treatment options for May-Thurner Syndrome are directed towards treating DVT due to the compression of the vein.
Some of the treatment options for DVT caused due to May-Thurner Syndrome are:
Anticoagulation: The patient suffering from May-Thurner Syndrome may be prescribed a blood thinner in order to prevent blood clots. The administration of a blood thinner may be done through an anticoagulation clinic so that the patient is treated in the best possible and safest way.
Catheter-Based Thrombolytic Therapy: This is a noninvasive treatment for May-Thurner Syndrome which uses medications that dissolves clots called as thrombolytics in order to dissolve the formed blood clots. The medications can be administrated through a catheter to where the volt has developed. Through this catheter, the thrombolytic is given. After administrating the medication, it may take from a few hours to a few days for the clots to dissolve. In extreme cases, angioplasty is also done after administration of the medication so as to prevent further clots from forming.
Angioplasty and Stents: Angioplasty is a noninvasive treatment in which the artery which had the clot is widened after the clot is dissolved. In angioplasty, a balloon is fitted at the tip of a catheter and the catheter is inserted into the narrowed artery and the balloon is inflated thus widening the artery and hence blood flow is increased. In some cases a stent is also placed in the narrowed artery so as to allow the artery to stay wide.
Vena Cava Filter: This form of treatment is reserved for patients who cannot take blood thinners or are not responsive to blood thinners. In this procedure, the filter is inserted through a catheter into a large vein in the groin or neck and then the vena cava which is the largest vein in the body. This allows it to catch the clot when it moves and prevents complications of DVTs.
What is the Prognosis of May-Thurner Syndrome?
The overall prognosis for patients with May-Thurner Syndrome is normally very good with treatment. In mild to moderate cases of clots, they can be completely treated with just medications alone whereas as acute cases may require treatments as described above to treat DVT caused by May-Thurner Syndrome.