Korean Circ J.  2004 Jul;34(7):655-659. 10.4070/kcj.2004.34.7.655.

Treatment of May-Thurner Syndrome with Catheter-Guided Local Thrombolysis and Stent Insertion

• Kim JY
• Choi D
• Ko YG
• Park S
• Jang Y
• Lee DY

• KMID: 1858917
• DOI: http://doi.org/10.4070/kcj.2004.34.7.655

Abstract

BACKGROUND
May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery, with the subsequent development of deep vein thrombosis and chronic venous insufficiency. Herein, our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome, using endovascular techniques, is reported.
METHODS
Twenty-one symptomatic patients, 8 men and 13 women, with a mean age of 51 years, were referred for treatment. Eighteen of these patients were treated with catheter-guided thrombolysis, but three, with short segment involvement, did not require thrombolysis. After completion of the thrombolytic therapy, the residual venous narrowing was treated by balloon angioplasty and/or self-expandable stent placement. Patients were then followed-up by clinic visits and venography.
RESULTS
The mean total dose of urokinase and duration of infusion were 4.28+/-1.89 million units and 72+/-35 hours, respectively. Eighteen of the 21 patient received stent deployments. The mean diameter of the stents was 12.9+/-2.0 mm. Initial technical success, with immediate symptom resolution, was achieved in 20 of the 21 patients (95%). Among the patients who received stent implantation, two had recurrent thrombotic occlusion during the follow-up period. (mean 10.8 months); all three patients who did not receive stent implantation had recurrent thromboses There were no major bleeding complications, with the exception of one patient who developed a retroperitoneal hematoma.
CONCLUSIONS
Catheter-guided thrombolysis and angioplasty with stent implantation are safe and effective for the treatment of May-Thurner syndrome.

Keyword

Venous thrombosis; Thrombolytic therapy; Stents

MeSH Terms

Ambulatory Care
Angioplasty
Angioplasty, Balloon
Endovascular Procedures
Female
Follow-Up Studies
Hematoma
Hemorrhage
Humans
Iliac Artery
Iliac Vein
Male
May-Thurner Syndrome*
Phlebography
Stents*
Thrombolytic Therapy
Thrombosis
Urokinase-Type Plasminogen Activator
Venous Insufficiency
Venous Thrombosis
Urokinase-Type Plasminogen Activator