May-Thurner Syndrome

An estimated 20% of the U.S. population have a vascular disorder known as May-Thurner Syndrome. It involves impingement of the main vein that travels into the left leg. This can cause mild to severe symptoms and complications as a result.

The primary concern of this condition is that it can lead to the formation of deep vein thrombosis, a blood clot in the deep veins of the legs than can become life-threatening should it travel to the lungs, triggering a pulmonary embolism.

What Is May-Thurner Syndrome?

May-Thurner Syndrome (MTS) involves an abnormality in the crisscross of arteries and veins in the pelvic region. It occurs when the right iliac artery compresses the left iliac vein that travels down into the left leg. This can constrict the vein, cause scarring, and increase your risk of developing blood clots and deep vein thrombosis (DVT) in left lower leg. For this reason, MTS is sometimes called iliac vein compression syndrome.

Symptoms & Complications

In many cases, those with the syndrome have no symptoms and may be unaware they have the condition. For them, the vein compression is slight and causes no noticeable symptoms. However, the

condition may progress from an asymptomatic stage as more severe compression of the vein occurs.

Often, by the time symptoms appear, it is likely that complications due to May-Thurner Syndrome – such as varicose veins, edema (swelling due to fluid buildup), and blood clots – have already occurred. Thus, the symptoms experienced are really symptoms of the complications of the condition.

Symptoms that occur tend to focus on the left leg and may include:

  • Generalized pelvic pain
  • Leg cramps
  • Heaviness in the leg
  • Leg pain and swelling
  • Pain that increases when standing or walking and decreases when legs are elevated
  • Noticeably enlarged veins in the leg
  • Discoloration in the skin of the leg
  • Nonhealing leg wounds

If symptoms occur, it may begin following a pregnancy or a period of immobility.

Who Is at Risk?

May-Thurner Syndrome is not passed down in families, but it does appear to be a structural abnormality that a person may be born with. It occurs in women far more often than men. The following are associated with an increased risk of symptomatic May-Thurner Syndrome:

  • Women 20 – 45 years old
  • Prior pregnancy
  • Women using hormonal birth control methods
  • Prolonged periods of inactivity
woman has varicose veins in her legs

Your Treatment Options for May-Thurner Syndrome

The goal of treating MTS is to alleviate a patient’s symptoms and reduce their risk of complications, especially blood clots.

The following treatment options address the possible complications of May-Thurner Syndrome, which is generally why a person seeks medical attention for the issue:

  • Compression garments to help push blood out of the legs
  • Maintaining a healthy weight
  • Exercises that work the calves to promote blood flow out of the legs
  • Medication
    • Anticoagulant medication to prevent blood clots
    • Clot-dissolving medications to eliminate existing blood clots
  • Vein ablation to destroy varicose veins, which reroutes blood to healthier nearby veins
  • Vein stenting to permanently prop open a vein after a blood clot has been dissolved
  • Vena cava filters can be placed to catch a blood clot before it gets to the lungs

Stenting, in particular, may be necessary to help prevent future blood clots from forming due to the compressed vein.

There are several surgeries that are designed to treat the underlying condition (the vein compression), including bypass surgery and surgery to reposition the right artery, so it is no longer putting pressure on the left iliac vein. In all cases, minimally invasive procedures are utilized wherever possible.

For Complex Vein Care Needs, Choose Dr. Mackay

Generally speaking, treatments are most successful the earlier medical attention is sought. When it comes to the risk of developing deep vein thrombosis (DVT), make sure you see a medical specialist well-versed in being able to properly identify and treat May-Thurner Syndrome as well as other venous diseases.

If you are concerned you may have May-Thurner Syndrome or another vein disorder, call Edward G. Mackay and Associates, LLC at (727) 781-5652 to schedule your visit with board-certified vascular surgeon Dr. Edward G. Mackay. You can also request an appointment now to visit us at one of our three convenient locations in Tampa Bay: in Palm Harbor, St. Petersburg, or Largo, Florida.