Department of Peripheral Vascular Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta Road, Xi'an, 710061, China.
BMC Cardiovasc Disord. 2020 May 19;20(1):233. doi: 10.1186/s12872-020-01515-z.
May-Thurner syndrome (MTS) or Cockett's syndrome is a rare clinical syndrome, which refers to the compression of the left common iliac vein (LCIV) by right common iliac artery and vertebral body. Complications of MTS include deep vein thrombus formation and even life-threatening pulmonary embolism.
Here, we report the case of a 60-year-old female patient with a complaint of swelling in the left lower limb and pain for 5 days. Computed tomography angiography indicated MTS, and thrombus formation of left external iliac vein and femoral vein. The patient was diagnosed with deep venous thrombosis (DVT) and MTS. The patient underwent ascending venography from the lower extremity to inferior vena cava (IVC) and then to the pulmonary artery with IVC filter implantation, left iliac vein balloon plasty, and stent placement. The patient visited the hospital for the removal of IVC filter, 28 days after the operation. After the interventional therapy, the patient had no in-stent restenosis and had remission during the 2-year follow-up.
This case presents a successful management of MTS in presence of DVT. Although clinicians are rarely aware, the presence of unilateral lower limb swelling and thrombosis may be the manifestations of MTS.
May-Thurner 综合征（MTS）或 Cockett 综合征是一种罕见的临床综合征，指的是左髂总静脉（LCIV）被右髂总动脉和椎体压迫。MTS 的并发症包括深静脉血栓形成，甚至危及生命的肺栓塞。
本案例报告了一位 60 岁女性患者，左下肢肿胀伴疼痛 5 天。计算机断层血管造影（CTA）提示 MTS，左髂外静脉和股静脉血栓形成。患者被诊断为深静脉血栓形成（DVT）和 MTS。患者行下肢顺行静脉造影至下腔静脉（IVC），然后至肺动脉，并植入 IVC 滤器，行左髂静脉球囊扩张和支架置入术。术后 28 天，患者来院取出 IVC 滤器。介入治疗后，患者支架内无再狭窄，随访 2 年无复发。
本病例成功治疗了 DVT 合并 MTS。尽管临床医生很少意识到，但单侧下肢肿胀和血栓形成可能是 MTS 的表现。
