May-Thurner Syndrome

Excerpt

May-Thurner syndrome (MTS) is described as compression of the left iliofemoral vein by the right common iliac artery against the vertebral body. It is also called Cockett syndrome or iliac vein compression syndrome. Rudolph Virchow, in 1851, first reported the increased incidence of the right common iliac artery compressing the left iliofemoral vein in the cadavers of patients with left iliofemoral thrombosis. However, it was not until 1957 when May and Thurner reported the presence of intraluminal fibrous bands in the left iliofemoral vein secondary to compression from the right common iliac artery in 22% of the 430 cadavers they dissected and called this finding MTS. Cockett and Thomas were the first to report these findings in living patients. Although, clinically, MTS is not a common cause of deep vein thrombosis (DVT), cadaveric and radiographic studies have reported a high incidence of compression of the left iliofemoral vein by the right common iliac artery. In this activity, we will discuss the incidence and pathophysiology of MTS and how to diagnose and treat this seemingly rare yet clinically silent syndrome.