The Radiologic Diagnosis and Result of Endovascular Management of May-Thurner Syndrome

Abstract

Introduction: This study aims to present the clinical and radiologic findings of 20 cases diagnosed with May-Thurner Syndrome, along with an assessment of radiologic treatment modalities and their outcomes. Methods: We enrolled 20 patients diagnosed with May-Thurner Syndrome based on radiologic assessments conducted at our hospital's radiology department. Cases with more than 80% iliac vein compression on Multidetector Computed Tomography (MDCT) venography underwent conventional venography for diagnosis confirmation and subsequent endovascular intervention. We analyzed the degree of compression, clinical and radiologic presentations, follow-up imaging, and treatment outcomes. Results: Among the cases, two were asymptomatic and incidentally discovered. Venous insufficiency was present in various forms: superficial-deep insufficiency in five cases, acute deep vein thrombosis (DVT) in one, chronic DVT in nine, and a combination of superficial-deep insufficiency with chronic DVT in three cases. MDCT venography was performed for all patients. Four patients received endovascular treatment, resulting in patent stents on follow-up MDCT imaging. Discussion and Conclusion: In patients exhibiting symptoms of venous insufficiency or recurrent DVT in the left lower extremity, considering May-Thurner Syndrome in the diagnostic process is crucial to ensure appropriate treatment and mitigate potential complications. Endovascular intervention represents a viable alternative to surgical approaches, particularly in cases demonstrating significant compression.