Percutaneous Treatment of Deep Vein Thrombosis in May-Thurner Syndrome

Journal Article · Tue Aug 15 04:00:00 EDT 2006 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-004-0165-7· OSTI ID:21091205

Kim, Jong-Youn; Choi, Donghoon; Guk Ko, Young; Park, Sungha; Jang, Yangsoo ^[1]; Lee, Do Yun ^[2]

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1. Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Cardiology Division (Korea, Republic of)
2. Yonsei University College of Medicine, Department of Diagnostic Radiology (Korea, Republic of)

Background/Purpose. May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery with subsequent development of deep vein thrombosis and chronic venous insufficiency. We report our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome using endovascular techniques. Methods. The study group comprised 21 patients (8 men, 13 women; mean age 51 years) diagnosed with May-Thurner syndrome by venogram. Eighteen patients were treated with catheter-guided thrombolysis; 3 patients 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 placement of a self-expandable stent. Results. The mean total dose of urokinase was 4.28 {+-} 1.89 million units, and the mean duration of infusion was 72 {+-} 35 hr. Eighteen of the 21 patients received stent deployment. The mean diameter of the stents was 12.9 {+-} 2.0 mm. Initial technical successes with immediate symptom resolution were achieved in 20 of the 21 patients (95%). We performed a follow-up venogram 6 months after procedure and checked clinical symptoms at outpatient clinics (mean follow-up duration 10.8 months). Among the patients who received stent implantation, 2 had recurrent thrombotic occlusion during the follow-up period. Three patients, who did not receive stent implantation, all had recurrent thrombosis. There were no major bleeding complications except in 1 patient who developed retroperitoneal hematoma. Conclusion. Catheter-guided thrombolysis and angioplasty with stent implantation is a safe and effective method for the treatment of May-Thurner syndrome.

• OSTI ID: 21091205
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 29; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
HEMATOMAS
INFUSION
PATIENTS
SYMPTOMS
THERAPY
THROMBOSIS
UROKINASE
VEINS