Surgical Thrombectomy and Simultaneous Stenting for Deep Venous Thrombosis Caused by Iliac Vein Compression Syndrome (May-Thurner Syndrome)

• Published in: Annals of Thoracic and Cardiovascular Surgery 2014, Vol.20(6), pp.995-1000
• Main Authors: Igari, Kimihiro, Kudo, Toshifumi, Toyofuku, Takahiro, Jibiki, Masatoshi, Inoue, Yoshinori
• Format: Article
• Language: English
• Subjects: Aged; deep venous thrombosis; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Female; Humans; Iliac Vein - diagnostic imaging; Iliac Vein - physiopathology; Iliac Vein - surgery; iliac vein compression syndrome; Male; May-Thurner syndrome; May-Thurner Syndrome - complications; May-Thurner Syndrome - diagnosis; May-Thurner Syndrome - physiopathology; May-Thurner Syndrome - surgery; Middle Aged; Phlebography - methods; stent placement; Stents; surgical thrombectomy; Thrombectomy - adverse effects; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler, Duplex; Vascular Patency; Venous Thrombosis - diagnosis; Venous Thrombosis - etiology; Venous Thrombosis - physiopathology; Venous Thrombosis - surgery
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.oa.13-00213

Purpose: Iliac vein compression syndrome (May-Thurner syndrome) is characterized by left iliac vein obstruction secondary to compression by the right common iliac artery against the fifth-lumbar vertebra, which increases incidence of deep venous thrombosis (DVT). We treated the patients with DVT due to May-Thurner syndrome (MTS) by surgical thrombectomy and simultaneous stenting, and this study is to evaluate the outcomes of this procedure.Methods: From January 2009 to December 2011, a total of 8 patients underwent surgical thrombectomy with stenting. All patients were admitted for acute DVT involving the left iliofemoral segment, and diagnosed MTS. Patients were followed-up, and stent patency was assessed by means of duplex sonography.Results: In all patients, the procedure was successful in achieving re-canalisation of the iliofemoral veins at the end of the operation. Perioperatively, there was no mortality and there was no case of clinically detected pulmonary embolism. Rethrombosis occurred within seven days of operation in 2 patients. During the follow-up period (mean; 16 months), 6 of 8 patients kept patent stents.Conclusion: Venous thrombectomy with simultaneous stenting is a potent technique to treat acute iliofemoral DVT due to MTS. This technique can restore venous patency and provide relief of the acute symptoms.