Case Report
Volume 3 Issue 11 - 2020
Unusual Presentation of May-Thurner Syndrome: A Case Report and Review of Literature
Ramy Ibrahim1*, Mazen M Salama2, Aghapy Kirolos3, Jose Ruben Hermann4 and Mina Khalil4
1Medical Director, Premier Medical Associates, The Villages, Florida, USA
2Healthcare Data Scientist MD MSc CPDS, Premier Medical Associates, The Villages, Florida, USA
3Research Assistant for Premier Medical Associates, The Villages, Florida, USA
4Clinical Care Coordinator, Premier Medical Associates, The Villages, Florida, USA
*Corresponding Author: Ramy Ibrahim, Medical Director, Premier Medical Associates, The Villages, Florida, USA.
Received: September 28, 2020; Published: October 19, 2020




Abstract

Iliac vein compression syndrome (IVCS) that presents with unclear etiology is known also as May-Thurner syndrome. The syndrome is due to the compression of the left common iliac vein occurring between the right common iliac artery and superior vertebrae leading to a rare presentation of deep vein thrombosis (DVT). It is uncommon for patients with an established diagnosis of IVCS to present with an obstruction of venous outflow or pulmonary emboli without the occurrence thrombosis in the deep venous system. A patient should be treated promptly to prevent life threatening consequences associated with the prior. Our case study presents a 46-year-old African American female without history of smoking or any other IVCS risk factors. We diagnosed her with a pulmonary emboli and a compressed left common iliac vein occurring without any symptoms in her lower extremities. The patient was successfully treated with catheter directed thrombolysis into the left iliac vein followed by therapeutic anticoagulation protocols.

Keywords: Iliac Vein Compression Syndrome (IVCS); Deep Vein Thrombosis (DVT); Pulmonary Embolism (PE)

References

  1. Lijfering WM., et al. “Risk factors for venous thrombosis - current understanding from an epidemiological point of view”. British Journal of Haematology 149 (2010): 824.
  2. Goldhaber SZ. “Risk factors for venous thromboembolism”. Journal of the American College of Cardiology 56 (2010): 1.
  3. Zander KD., et al. “May-Thurner Syndrome resulting in acute iliofemoral deep vein thrombosis in the postpartum period”. Obstetrics and Gynecology 2-2 (2008): 565-569.
  4. Kibbe MR., et al. “Iliac vein compression in an asymptomatic patient population”. Journal of Vascular Surgery 39 (2004): 937.
  5. Fazel R., et al. “Clinical problem-solving. A sinister development--a 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma”. The New England Journal of Medicine 357 (2007): 53.
  6. Carr S., et al. “Correlation of the diameter of the left common iliac vein with the risk of lower-extremity deep venous thrombosis”. Journal of Vascular and Interventional Radiology 23 (2012): 1467.
  7. Patel NH., et al. “Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome”. Journal of Vascular and Interventional Radiology 11 (2000): 1297.
  8. Sharaf M. “Recurrent left-leg venous thrombosis in a woman despite a therapeutic international normalized ratio”. Canadian Medical Association Journal 173 (2005): 1032.
  9. Lamont JP., et al. “Prospective evaluation of endoluminal venous stents in the treatment of the May-Thurner syndrome”. Annals of Vascular Surgery 16 (2002): 61.
  10. Chee YL., et al. “Inferior vena cava malformation as a risk factor for deep venous thrombosis in the young”. British Journal of Haematology 114 (2001): 878.
  11. Kibbe MR., et al. “Iliac vein compression in an asymptomatic patient population”. Journal of Vascular Surgery 39 (2004): 937.
  12. O'Sullivan GJ., et al. “Endovascular management of iliac vein compression (May-Thurner) syndrome”. Journal of Vascular and Interventional Radiology 11 (2000): 823.
  13. Motwani J., et al. “An unusual case of venous thromboembolism”. British Journal of Haematology 128 (2005): 1.
  14. Lambert M., et al. “Inferior vena cava agenesis and deep vein thrombosis: 10 patients and review of the literature”. Vascular Medicine 15 (2010): 451.
  15. Tsai AW., et al. “Coagulation factors, inflammation markers, and venous thromboembolism: the longitudinal investigation of thromboembolism etiology (LITE)”. The American Journal of Medicine 113 (2002): 636.
  16. Levent Oğuzkurt., et al. “Ultrasonographic diagnosis of iliac vein compression (May-Thurner) syndrome”. Diagnostic and Interventional Radiology 3 (2007): 152-155.
  17. M Loukas., et al. “A case of May-Thurner syndrome”. Folia Morphologica 67 (2008): 214-217.
  18. Sonia Cerquozzi., et al. “Iliac Vein Compression Syndrome in an Active and Healthy Young Female”. Case Reports in Medicine (2012): 786876.
Citation: Ramy Ibrahim., et al. “Unusual Presentation of May-Thurner Syndrome: A Case Report and Review of Literature”. EC Clinical and Medical Case Reports 3.11 (2020): 30-34.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk