May-Thurner Procedure
May-Thurner May-Thurner syndrome (MTS) is caused when the left iliac vein is compressed by the right iliac artery, which increases the risk of deep vein thrombosis (DVT) in the left extremity. DVT is a blood clot that may partially or completely block blood flow through the vein. Many people do not know they have MTS, but it is identified when they present with a DVT. Patients should seek treatment for symptoms, including swelling, pain or tenderness in the leg, feeling of increased warmth in the leg, redness or discoloration of the skin, or enlargement of the veins in the leg. When a person has had a DVT due to MTS the veins draining the left leg can become scarred down and obstructed. Angioplasty is a nonsurgical treatment option that may be used to widen and narrowed or obstructed vein. During angioplasty, a small balloon at the tip of the catheter is inflated to stretch the vein open and increase blood flow. A stent is often placed during the angioplasty procedure to keep the vein open. A stent is a small, metal mesh tube that acts as a scaffold and provides support inside the vein. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed vein. Stenting of the iliac vein is often important in the treatment of MTS. The procedure can be done either from the left or right groin. The following images are from a patient recently treated with angioplasty and stenting. The patient suffered from a left leg DVT many years ago which was treated with a blood thinner. Over the years the patient suffered from chronic leg swelling, pain, and fatigue. In the first image you can appreciate the obstructed left iliac vein. The second image depicts collateral veins that are compensating for the obstructed iliac vein. Once angioplasty was performed, 3 stents were placed across the previously blocked iliac vein which can be seen in the third image. Finally in the last image, blood flow can be seen through the stent within the iliac vein. This procedure was done through the right groin.