REVIEW  LATEST FRONTIERS OF HEMODYNAMICS, IMAGING AND TREATMENT OF OBSTRUCTIVE VENOUS DISEASE 

Italian Journal of Vascular and Endovascular Surgery 2018 September;25(3):252-61

DOI: 10.23736/S1824-4777.18.01352-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

May-Thurner syndrome and chronic iliofemoral vein occlusions

Arjun JAYARAJ ✉, Seshadri RAJU

The RANE Center for Venous and Lymphatic Diseases, St. Dominic Hospital, Jackson, MS, USA

May and Thurner gave a histologic basis to the acquired etiology of obstructive lesions at the iliocaval junction noting that the obstructive spur was composed of loose endothelialized connective tissue instead of smooth muscle and elastic fibers as would be the case if the lesion were ontogenetic. Their hypothesis was that the lesion arose due to trauma from the overlying pulsating artery. Currently, an acquired etiology is generally accepted though a few lesions could be ontogenic as they occur at known fusion planes. A recent cross-sectional imaging study has demonstrated that up to 66% of individuals can have 25% or greater compression of the left common iliac vein. Increased use of intravascular ultrasound for the diagnosis and treatment of chronic venous insufficiency has demonstrated the presence of a compressive lesion in a wider set of locations in the pelvis than previously considered. Additionally, it also appears to affect a wider swathe of the population than formerly thought. The present review provides an overview on the clinical features of the May-Thurner syndrome and on the current diagnostic and therapeutic strategies.

KEY WORDS: May-Thurner Syndrome - Venous insufficiency - Peripheral vascular disease