May-Thurner Syndrome

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May-Thurner syndrome is the narrowing of the vein that runs from the left leg (left common iliac vein) to the large vein in the abdomen that leads to the heart. May-Thurner syndrome can lead to leg pain and swelling or even deep vein thrombosis.

Causes of May-Thurner Syndrome

May-Thurner syndrome occurs when the artery that runs to the right leg (right common iliac artery) compresses the left iliac vein against the spine. The left iliac vein then becomes narrowed and scarred. While the right common iliac artery normally runs over the left common iliac vein, it does not usually cause pressure and narrowing of the vein.

Symptoms of May-Thurner Syndrome

Patients with May-Thurner syndrome may not have any symptoms. However, symptoms can occur with more severe cases and include:

  • Leg swelling and pain
  • Blood clots
  • Deep vein thrombosis

Diagnosis & Treatment at UVA

At UVA, we can diagnose you by using these tests:

  • Ultrasound imaging
  • Magnetic resonance imaging (MRI) or computed tomography (CT) scans
  • Venogram or phlebogram

Surgical options for treating May-Thurner syndrome include:

  • Stenting: A stent works to hold the vein open and relieve the blockage in the vein. This minimally invasive procedure requires a small incision rather than open surgery. 
  • Bypass surgery: Blood flow is rerouted around the narrowed portion of the vein using a bypass graft.
  • Repositioning the right common iliac artery: The artery is surgically moved behind the left common iliac vein so that the artery no longer puts pressure on the vein.
  • Building a tissue "sling": Tissue is surgically placed between the left common iliac vein and the right common iliac artery to lift the artery, so it no longer places pressure on the vein.
  • Removal of a blood clot: If the vein in the pelvis is full of blood clots and the leg is swollen, the blood clot can be removed using blood-clot dissolving medicine along with a device that helps break up and remove the clot. Surgery or stent placement is not performed until the clot is removed.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.