Role of Interventional Cardiologists in Lower Limb Swelling/DVT -Case Series on May-Thurner Syndrome and its Variants

Abstract

May-Thurner syndrome is a disorder of left common iliac vein compression by an overriding right common iliac artery that leads to deep venous thrombosis (DVT), commonly seen in young to middle-aged women. This obstruction may cause leg swelling, varicosities, deep venous thrombosis, chronic venous stasis ulcers, or more serious complications, such as pulmonary embolism. The diagnosis requires high clinical suspicion. Computed tomography venography depicts the extent of venous thrombosis and iliac venous compression in patients with underlying thrombotic and non-thrombotic pathologies. Endovascular ultrasound is highly useful to detect early mural changes and accurately quantify venous narrowing. Endovascular intervention with balloon dilatation and stenting with or without pharmacomechanical thrombectomy followed by long-term anticoagulation is the preferred treatment. We report a series of 9 patients presenting with deep vein thrombosis, varicosities and leg ulcers diagnosed by peripheral angiography and CT Venography. 8 patients received the percutaneous intervention (6 stenting and 2 balloon dilatation), 1 patient received medical management.