Endovascular and medical therapy of May–Thurner syndrome: Case series and scoping literature review

2021 
Summary Introduction May–Thurner syndrome has been recognized as a cause of chronic venous insufficiency and a trigger for venous thromboembolism. There is no consensus about the definition, diagnosis, and therapeutic approach. We are aiming to describe its characteristics and a scoping literature review. Methods A retrospective review of patients with May–Thurner syndrome from March 2010 to May 2018 and scoping literature review were made. Results Seven patients were identified. All patients were female with a median age of 36 (20–60) years. The median time from the first symptom to diagnosis was 3.41 (0.01–9) years. The primary clinical presentation was post-thrombotic syndrome (4 patients). Six patients had at least one risk factor for deep venous thrombosis. All patients underwent angioplasty with stent; patients with acute deep venous thrombosis, furthermore mechanic thrombectomy with or without catheter-directed thrombolysis were done. There were three complications (one patient, lymphedema, and two venous stent thrombosis). Scoping review results were descriptively summarized. Conclusion May–Thurner syndrome has a varied spectrum of clinical presentation, and clinical awareness is paramount for diagnosis. Its principal complication is the post-thrombotic syndrome, which is associated with high morbidity. There is no consensus on the antithrombotic treatment approach.
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