PDF(Pubmed)
Abstract：
May-Thurner syndrome (MTS) is a rare cause of deep venous thrombosis (DVT), characterized by the external compression of the left common iliac vein by the right common iliac artery against bony structures. Risk factors for MTS include female sex (postpartum, multiparous, and using oral contraceptive pills), spinal abnormalities like scoliosis, prior aortoiliac vascular stent placement, dehydration, and hypercoagulability. MTS patients with partial obstruction can be asymptomatic, but progression to extensive symptomatic DVT and/or chronic venous insufficiency can occur. MTS can be diagnosed by non-invasive imaging studies including ultrasound (US), computed tomography (CT) scan, magnetic resonance imaging (MRI), venogram, catheter-based venogram, and intravascular US. For MTS patients with moderate to severe symptoms, we suggest thrombectomy, angioplasty, and stenting of the affected segment. In this case report, we highlight a 44-year-old male with a recent diagnosis of left-sided DVT on apixaban who presented with worsening leg swelling. DVT, pulmonary embolism (PE), and MTS were diagnosed with a lower extremity US, chest CT angiography, and abdominal/pelvic CT scan and venography, respectively. The patient underwent interventional radiology-guided local thrombolysis, thrombectomy, and venoplasty along with stent placement in the left common iliac vein. Subsequently, the patient was discharged on rivaroxaban.
摘要：
May-Thurner综合征（MTS）是深静脉血栓形成（DVT）的罕见病因，以右髂总动脉对骨性结构的左髂总静脉的外部压迫为特征。MTS的危险因素包括女性(产后，多胎,并使用口服避孕药)，脊柱异常像脊柱侧凸,前主动脉血管支架置入术，脱水,和高凝状态。部分梗阻的MTS患者可以无症状，但可进展为广泛症状性DVT和/或慢性静脉功能不全.MTS可以通过包括超声（US）在内的非侵入性成像研究来诊断。计算机断层扫描(CT)扫描,磁共振成像（MRI），静脉造影,基于导管的静脉造影,和血管内美国。对于中度至重度症状的MTS患者，我们建议血栓切除术,血管成形术,和受影响的节段的支架。在这个案例报告中,我们重点介绍了一名44岁男性,其最近诊断为阿哌沙班患者左侧DVT,表现为腿部肿胀恶化.DVT,肺栓塞(PE),MTS被诊断为下肢US，胸部CT血管造影，腹部/盆腔CT扫描和静脉造影，分别。患者接受了介入放射学引导的局部溶栓，血栓切除术,和静脉成形术以及左髂总静脉支架置入术。随后，患者使用利伐沙班出院。
