Woo Edward J, Ogilvie Ross A, Krueger Van Schaumburg, Lundin Michael, Williams David M
Department of Surgery, Michigan State University, Lansing, MI, USA
Department of Radiology, Loyola University Medical Center, Maywood, IL, USA.
J Surg Case Rep. 2016 Feb 23;2016(2):rjw003. doi: 10.1093/jscr/rjw003.
May-Thurner syndrome is an anatomic variant where the right common iliac artery compresses the left common iliac vein. The variant exists in a significant portion of the population, but is usually asymptomatic; however, clinically significant stenosis can occur by iatrogenic means. In this report, we describe a patient who presents with left lower extremity pain and swelling. Initial workup for deep vein thrombosis was negative. After being referred to our venous clinic, a magnetic resonance angiography revealed narrowing of the left common iliac vein with a tortuous right common iliac artery crossing over the constriction. During left iliac vein stent placement, a pedicle screw from a prior L2-S1 spinal fusion was noted to be perforated through L5 vertebral body impinging the posterior aspect of the vein. This case demonstrates that increased scrutiny must be applied when dealing with pathology in close proximity to any implanted medical device.
梅-图二氏综合征是一种解剖变异，即右髂总动脉压迫左髂总静脉。这种变异存在于相当一部分人群中，但通常无症状；然而，临床上显著的狭窄可通过医源性方式发生。在本报告中，我们描述了一名出现左下肢疼痛和肿胀的患者。最初对深静脉血栓形成的检查结果为阴性。在转诊至我们的静脉诊所后，磁共振血管造影显示左髂总静脉狭窄，右髂总动脉迂曲并横跨狭窄处。在进行左髂静脉支架置入时，发现一枚来自先前L2-S1脊柱融合术的椎弓根螺钉穿过L5椎体，压迫静脉后侧。该病例表明，在处理紧邻任何植入式医疗设备的病变时，必须加强仔细检查。
