What is May-Thurner Syndrome?
The body relies on pressure systems to deliver blood throughout the body. Just as the plumbing in your house can have clogs, and low- and high-pressure issues, so can your body. Arteries have a higher-pressure system than veins. When there is a struggle for space in a tight area, such as your pelvis, the artery always wins and can compress the vein. When the right iliac artery is pushing against the left iliac vein in your lower pelvic region this is referred to as May-Thurner Syndrome (MTS). The most common is for this compression to occur on the left side of the pelvis and the syndrome is two times more likely to occur in women than men. Many people live with this syndrome happily going through their lives asymptomatic and unaware of the pressure battle occurring deep within their pelvis. The problem transpires when the venous compression becomes symptomatic.
What are the symptoms?
· Left leg swelling, pain, and redness
· Lower pelvic pain and heaviness
· Leg ulcers/wounds
· Varicose veins
Why does a person suddenly become symptomatic?
Most women and men become symptomatic from ages 20 to 40 following an event. The event could be a long car-ride or plane trip, pregnancy, starting on oral contraceptives, or trauma. Our bodies are very good at compensating by forming collateral circulation to circumvent the compression. If a wrench, or causative effect, is thrown into the system, the body can no longer compensate, and symptoms begin to appear. If a patient becomes symptomatic, intervention is vital as the blood clots (deep vein thrombosis or DVTs) formed due to compression of the vein can be life threatening. Further, the symptoms of MTS can be painful and intrude on our daily lives.
How is symptomatic May Thurner Syndrome treated?
· Blood thinning medication
· Thrombectomy medication
· Mechanical thrombectomy
· Stent Placement
Blood thinning medication and thrombectomy medication (anticoagulation therapy) are the least invasive means of caring for any blood clots, DVTs, that may form, they are less likely to be adequate in the long run to treat the root cause of the problem. The clots are springing from an actual blockage, and that needs to be “roto-rootered” and a stent placed to keep the vein open. These procedures can be performed in a special surgical area called Interventional Radiology. Advantageously, most procedures are outpatient, and with less than a week of recovery time.
May Thurner Syndrome can be painful and interrupt your life, but there is no reason why it should continue to do either one of these. Simple procedures and medications can eliminate pain and debilitation with little down time. It’s easy to speak to your primary care physician if you are experiencing any of the tell-tale symptoms and to start treatment early.
References
Mangla, A., & Hamad, H. (2022, November 30). May-thurner syndrome. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK554377/
Peters, M., Syed, R. K., Katz, M., Moscona, J., Press, C., Nijjar, V., Bisharat, M., & Baldwin, D. (2012, July). May-Thurner Syndrome: A not so uncommon cause of a common condition. Proceedings (Baylor University. Medical Center). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377287/ Assessed and Endorsed by the MedReport Medical Review Board