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Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report.
Int J Angiol. 2019 Dec; 28(4):262-266.IJ

Abstract

May-Thurner's syndrome (MTS) is an anatomical variant where the left common iliac vein (CIV) is compressed by the overlying right common iliac artery and the underlying lumbar vertebrae, leading to stenosis in the left CIV. Endovascular intervention followed by anticoagulation currently constitute the mainstay of management of MTS associated with recurrent deep vein thrombosis (DVT). Warfarin appears to be the anticoagulant of choice in most studies conducted in patients with MTS. There is little evidence of treatment using nonvitamin K oral anticoagulants. This case report serves to describe a patient with MTS who was successfully treated with catheter-directed therapy followed by anticoagulation using rivaroxaban. A 64-year-old women presented with left lower limb swelling. Her duplex ultrasound and computed tomography (CT) showed extensive DVT and underlying narrowing of the left CIV, respectively. She underwent catheter-directed therapy, involving stent placement in the left CIV, and was subsequently started on rivaroxaban. She developed partial thrombosis of the external iliac vein at 5 months postprocedure and partial stent thrombosis at 1 year postprocedure while on rivaroxaban, requiring repeat stenting and continuation of anticoagulation. On follow-up, there was no recurrence of symptoms related to MTS, no postthrombotic syndrome, and no clinically significant bleeding as a side effect of rivaroxaban. This case report shows that rivaroxaban is a safe agent that can be successfully used in the treatment of MTS after stenting.

Authors+Show Affiliations

Department of General Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.Department of General Medicine, Subspecialty of Vascular Medicine and Hypertension, Tan Tock Seng Hospital, Singapore, Singapore.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31787826

Citation

Han, Toh Ching, and Ashish Anil Sule. "Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome With a Novel Oral Anticoagulant: a Case Report." The International Journal of Angiology : Official Publication of the International College of Angiology, Inc, vol. 28, no. 4, 2019, pp. 262-266.
Han TC, Sule AA. Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report. Int J Angiol. 2019;28(4):262-266.
Han, T. C., & Sule, A. A. (2019). Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report. The International Journal of Angiology : Official Publication of the International College of Angiology, Inc, 28(4), 262-266. https://doi.org/10.1055/s-0038-1661003
Han TC, Sule AA. Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome With a Novel Oral Anticoagulant: a Case Report. Int J Angiol. 2019;28(4):262-266. PubMed PMID: 31787826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Deep Vein Thrombosis in May-Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report. AU - Han,Toh Ching, AU - Sule,Ashish Anil, Y1 - 2018/06/20/ PY - 2020/12/01/pmc-release PY - 2019/12/3/entrez PY - 2019/12/4/pubmed PY - 2019/12/4/medline KW - DVT KW - anticoagulation KW - artery KW - common iliac vein KW - deep vein thrombosis KW - endovascular therapy KW - venous outflow SP - 262 EP - 266 JF - The International journal of angiology : official publication of the International College of Angiology, Inc JO - Int. J. Angiol. VL - 28 IS - 4 N2 - May-Thurner's syndrome (MTS) is an anatomical variant where the left common iliac vein (CIV) is compressed by the overlying right common iliac artery and the underlying lumbar vertebrae, leading to stenosis in the left CIV. Endovascular intervention followed by anticoagulation currently constitute the mainstay of management of MTS associated with recurrent deep vein thrombosis (DVT). Warfarin appears to be the anticoagulant of choice in most studies conducted in patients with MTS. There is little evidence of treatment using nonvitamin K oral anticoagulants. This case report serves to describe a patient with MTS who was successfully treated with catheter-directed therapy followed by anticoagulation using rivaroxaban. A 64-year-old women presented with left lower limb swelling. Her duplex ultrasound and computed tomography (CT) showed extensive DVT and underlying narrowing of the left CIV, respectively. She underwent catheter-directed therapy, involving stent placement in the left CIV, and was subsequently started on rivaroxaban. She developed partial thrombosis of the external iliac vein at 5 months postprocedure and partial stent thrombosis at 1 year postprocedure while on rivaroxaban, requiring repeat stenting and continuation of anticoagulation. On follow-up, there was no recurrence of symptoms related to MTS, no postthrombotic syndrome, and no clinically significant bleeding as a side effect of rivaroxaban. This case report shows that rivaroxaban is a safe agent that can be successfully used in the treatment of MTS after stenting. SN - 1061-1711 UR - https://www.unboundmedicine.com/medline/citation/31787826/Treatment_of_Deep_Vein_Thrombosis_in_May-Thurner's_Syndrome_with_a_Novel_Oral_Anticoagulant:_A_Case_Report L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0038-1661003 DB - PRIME DP - Unbound Medicine ER -
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