May-Thurner Syndrom

Today’s case 11 – May-Thurner syndrome

Today I will introduce May-Thurner syndrome induced DVT and its treatment

I’m not sure why, but lately there seems to be an unusually high number of patients with Deep Vein Thrombosis (DVT) caused by May-Thurner Syndrome.

Personally, I think it might be related to the current cold weather in Korea. People are likely spending more time indoors and engaging in less physical activity, which could possibly contribute to a higher incidence of DVT.

This is just a speculation, though, without any solid evidence.

The patient is 53-year-old male.

The patient was referred to our facility following a diagnosis of Deep Vein Thrombosis (DVT).

Their primary concern was the sudden onset of swelling in the left lower limb, which had been present for two days.

May-Thurner syndrome — CT scan which was taken outside hospital revealed Deep vein thrombosis (DVT) extenting from Lt. common iliac vein to Lt. popliteal vein.

The patient reffered for interventional procedure to interventional radiology department.

Consistent with our standard protocol, plans were made for the insertion of an IVC filter, thrombectomy, and stenting of the left common iliac vein.

After puncturing the left popliteal vein, a 5F multipurpose catheter was introduced through a 9F sheath, chosen to accommodate subsequent stent insertion.

Upon gentle injection of contrast, an extensive filling defect indicative of thrombosis was observed.

We utilized the AngioJet™ Peripheral Thrombectomy System from Boston Scientific for the procedure.

A power pulse injection of recombinant tissue plasminogen activator (r-tPA) was administered, followed by a 10-minute waiting period to allow for effective thrombolysis, which is essential for the subsequent aspiration of the thrombus.

Finally, rheolytic thrombectomy was carried out from the proximal to the distal sections, starting from the left common iliac vein and extending to the left popliteal vein