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May-Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males.
Case Rep Med. 2020; 2020:2324637.CR

Abstract

May-Thurner syndrome (MTS) is an underdiagnosed cause of lower limb deep vein thrombosis (DVT). The clinical prevalence of MTS-related DVT is likely underestimated, particularly in patients with other more recognisable risk factors. MTS is classically described in females between the age group of 20-50 years. In patients with acute iliofemoral thrombosis, medical treatment with anticoagulation alone has been associated with higher risk of postthrombotic syndrome (PTS) and lower iliofemoral patency rates, as compared to endovascular correction. We describe a case of MTS-related extensive iliofemoral DVT occurring in a middle age male who presented with acute onset of left lower limb swelling and pain, complicated by pulmonary embolism. Doppler compression ultrasonography of the left lower limb showed partial DVT extending from the left external iliac to the popliteal veins, and contrasted computed tomography (CT) of the thorax abdomen and pelvis established features of MTS, together with right pulmonary embolism. He was started on low molecular weight heparin (LMWH) and then underwent left lower limb AngioJet pharmacomechanical thrombolysis/thrombectomy, iliac vein stenting, and temporary inferior vena cava (IVC) filter insertion. After the procedure, the patient recovered and improved symptomatically with rapid resolution of this left lower limb swelling and pain. He was switched to an oral Factor Xa inhibitor and was subsequently discharged. After 1-month follow-up, he remained well with stent patency visualised on repeat ultrasound and underwent an uneventful elective IVC filter retrieval with subsequent plans for a 1-year follow-up.

Authors+Show Affiliations

Department of Internal Medicine, Singapore General Hospital, Singapore.Vascular and Endovascular Service, Department of General Surgery, Sengkang General Hospital, Singapore.Vascular and Endovascular Service, Department of General Surgery, Sengkang General Hospital, Singapore.Internal Medicine, Department of General Medicine, Sengkang General Hospital, Singapore.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32536943

Citation

Tian En Jason, Tay, et al. "May-Thurner Syndrome: a Consideration for Deep Vein Thrombosis in Males." Case Reports in Medicine, vol. 2020, 2020, p. 2324637.
Tian En Jason T, Jia Sheng T, Choke TCE, et al. May-Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males. Case Rep Med. 2020;2020:2324637.
Tian En Jason, T., Jia Sheng, T., Choke, T. C. E., & Sachdeva, P. (2020). May-Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males. Case Reports in Medicine, 2020, 2324637. https://doi.org/10.1155/2020/2324637
Tian En Jason T, et al. May-Thurner Syndrome: a Consideration for Deep Vein Thrombosis in Males. Case Rep Med. 2020;2020:2324637. PubMed PMID: 32536943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - May-Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males. AU - Tian En Jason,Tay, AU - Jia Sheng,Tay, AU - Choke,Tieng Chek Edward, AU - Sachdeva,Pooja, Y1 - 2020/05/23/ PY - 2020/03/08/received PY - 2020/04/21/revised PY - 2020/05/08/accepted PY - 2020/6/16/entrez SP - 2324637 EP - 2324637 JF - Case reports in medicine JO - Case Rep Med VL - 2020 N2 - May-Thurner syndrome (MTS) is an underdiagnosed cause of lower limb deep vein thrombosis (DVT). The clinical prevalence of MTS-related DVT is likely underestimated, particularly in patients with other more recognisable risk factors. MTS is classically described in females between the age group of 20-50 years. In patients with acute iliofemoral thrombosis, medical treatment with anticoagulation alone has been associated with higher risk of postthrombotic syndrome (PTS) and lower iliofemoral patency rates, as compared to endovascular correction. We describe a case of MTS-related extensive iliofemoral DVT occurring in a middle age male who presented with acute onset of left lower limb swelling and pain, complicated by pulmonary embolism. Doppler compression ultrasonography of the left lower limb showed partial DVT extending from the left external iliac to the popliteal veins, and contrasted computed tomography (CT) of the thorax abdomen and pelvis established features of MTS, together with right pulmonary embolism. He was started on low molecular weight heparin (LMWH) and then underwent left lower limb AngioJet pharmacomechanical thrombolysis/thrombectomy, iliac vein stenting, and temporary inferior vena cava (IVC) filter insertion. After the procedure, the patient recovered and improved symptomatically with rapid resolution of this left lower limb swelling and pain. He was switched to an oral Factor Xa inhibitor and was subsequently discharged. After 1-month follow-up, he remained well with stent patency visualised on repeat ultrasound and underwent an uneventful elective IVC filter retrieval with subsequent plans for a 1-year follow-up. SN - 1687-9627 UR - https://www.unboundmedicine.com/medline/citation/32536943/May-Thurner_Syndrome:_A_Consideration_for_Deep_Vein_Thrombosis_in_Males L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32536943/ DB - PRIME DP - Unbound Medicine ER -
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