Acta Scientific Clinical Case Reports

Short Communication Volume 3 Issue 1

MTS, A Commonly Missed Diagnosis

Ayman Eltayeb E Ahmed*

Vascular Surgeon and Assistant Professor, Department of Surgery, Division of Vascular, Endovascular, and Wound Surgery, University of Toledo, OH, USA, USA

*Corresponding Author: Ayman Eltayeb E Ahmed, Vascular Surgeon and Assistant Professor, Department of Surgery, Division of Vascular, Endovascular, and Wound Surgery, University of Toledo, OH, USA, USA.

Received: November 22, 2021; Published: December 09, 2021

May Thurner syndrome (MTS) is an anatomically variable condition of venous outflow obstruction caused by extrinsic obstruction [1], resulting in an acquired stenosis commonly of the left common iliac vein secondary to compression by the overlying right common iliac artery [2]. Venous outflow obstruction in young adults was not well understood until 1957 when Dr. Robert May and Dr. Joseph Thurner concluded in their study of 430 cadavers that thrombosis of the pelvic veins occurs approximately eight times more frequently on the left side than on the right side of the pelvis. They attributed this to spur-like formations in the left common iliac vein and described three types of these formations. The first protrudes into the lumen like a pier or pillar, the second divides the lumen completely, and the third obstructs it almost entirely. Based on their histologic data, they reported that those formations are not of a congenital origin but develop during the patient’s lifetime [3]. The exact prevalence of MTS is not well known. Many studies estimated an asymptomatic anatomical variant in the general population to be 22-32% [3-5].

References

  1. Mousa AY and AbuRahma AF. “May-Thurner syndrome: update and re-view”. Annals of Vascular Surgery 27 (2013): 984-995.
  2. Alnasif A., et al. “Unusual presentation of right sided May-Thurner syndrome”. Journal of Vascular Surgery Cases, Innovations and Techniques 4 (2021): 768-771.
  3. May R and Thurner J. “The cause of the predominantly sinistral occur- rence of thrombosis of the pelvic veins”. Angiology 8 (1957): 419-427.
  4. McMurrich JP. “The occurrence of congenital adhesions in the com- mon iliac veins and their relation to thrombosis of the femoral and iliac veins”. The American Journal of the Medical Sciences 135 (1908): 342-346.
  5. Ehrich WE and Krumbhaar EB. “A frequent obstructive anomaly of the mouth of the left common iliac vein”. American Heart Journal 26 (1943): 737-750.
  6. Cockett FB and Thomas ML. “The iliac compression syndrome”. British Journal of Surgery 52 (1965): 816-821.
  7. Murphy EH., et al. “Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner syndrome”. Journal of Vascular Surgery 49 (2009): 697e703.
  8. Messina LM., et al. “Clinical signifi- cance of routine imaging of iliac and calf veins by color flow duplex scanning in patients suspected of having acute lower extremity deep venous thrombosis”. Surgery 114 (1993): 921e7.
  9. O’Sullivan GJ., et al. “Endovascular management of iliac vein compression (May-Thurner) syndrome”. Journal of Vascular and Interventional Radiology 11 (2000): 823e36.
  10. Hurst DR., et al. “Diagnosis and endovascular treatment of iliocaval compression syndrome”. Journal of Vascular Surgery 34 (2001): 106e13.
  11. Hung JB., et al. “Prostatism and May-Thurner syndrome”. American Journal of Emergency Medicine 31 (2013): 445.
  12. Wasserburger J., et al. “Lumbosacral exostosis as a rare cause of iliac vein compression and significant limb swelling”. Journal of Vascular Surgery Cases, Innovations and Techniques 5 (2019): 529-531.
  13. Tai E., et al. “Diagnosis and management of right external iliac vein "sandwich": a rare cause of iliofemoral deep venous thrombosis”. Journal of Vascular Surgery Cases, Innovations and Techniques 5 (2019): 314-318.

Citation

Citation: Ayman Eltayeb E Ahmed. “MTS, A Commonly Missed Diagnosis". Acta Scientific Clinical Case Reports 3.1 (2022): 19-20.

Copyright

Copyright: © 2022 Ayman Eltayeb E Ahmed. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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