The syndrome is rarely diagnosed, but the vein compression that causes it is present in about 1 in 5 people, according to some estimates. Here’s what to know.
What is May-Thurner syndrome?
May-Thurner syndrome occurs when the left iliac vein — which carries blood from the left leg back to the heart — is compressed by the right iliac artery where they cross in the pelvis, according to the Cleveland Clinic. This makes it more difficult for blood to flow back to the heart and can result in deep vein thrombosis, when a blood clot forms in the deep veins, usually in the legs.
Such clots may break loose and get stuck in the lungs, blocking blood flow in what is known as a pulmonary embolism, which can be life-threatening.
Many people who have May-Thurner syndrome don’t experience symptoms. The condition is more common in people between the ages of 20 and 40 who have been pregnant, according to the University of Maryland Medical Center.
While the syndrome was initially presumed to be rare when it was anatomically defined in 1957 by the researchers it is named after, reports have become more frequent, and there is speculation it may be more prevalent “than generally perceived,” according to a 2020 paper by researchers from the University of Minnesota.
May-Thurner syndrome is also known as iliac vein compression syndrome or Cockett syndrome, after one of the researchers who first reported on the condition in living patients.
What causes May-Thurner syndrome?
Experts aren’t sure why such vein compression happens, according to the Cleveland Clinic.
The 2020 paper suggests that one reason for underdiagnosis of the condition could be that people may not be symptomatic until “provoked by instances of increased hypercoagulability,” or increased tendency to form blood clots, such as during travel or postpartum.
Related risk factors include pregnancy, the use of oral contraceptives, recent surgery and trauma to the veins, according to Northwell Health.
What are the symptoms of May-Thurner syndrome?
Symptoms include swelling, feelings of fullness or heaviness in legs or feet; venous ulcers; and varicose veins, according to the University of Pittsburgh Medical Center. Symptoms usually occur in the left leg, per the Cleveland Clinic, and can include skin discoloration and pain.
An imaging test such as a CT scan or an MRI is usually used to diagnose the condition.
Treatment depends on symptoms and can include the use of blood thinners, compression stockings, stenting or thrombolysis, which uses medicine to break down clots. Surgery may also be used in some cases to reposition the artery to avoid compression or to bypass the part of the vein that has been narrowed.
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