Dunlap Eleanor, Fitzpatrick Suzanna, Nagarsheth Khanjan
Vascular Surgery, University of Maryland Medical Center, Baltimore, USA.
Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA.
Cureus. 2023 Mar 10;15(3):e35984. doi: 10.7759/cureus.35984. eCollection 2023 Mar.
May-Thurner (MT) syndrome refers to compression of the left common iliac vein by the right common iliac artery. Symptoms reported are generally left-sided leg swelling or pain. It is unusual for patients to report right-sided symptoms that are alleviated by treating MT compression. This case series describes three patients who had right-sided symptoms caused by left-sided venous compression. A retrospective chart review identified three patients over a year who presented with a variety of symptoms, including right-leg pain and swelling, and underwent treatment with left-sided venous compressions with a resolution of symptoms. Three patients were identified with right-sided back and flank pain. Venography with intravascular ultrasound (IVUS) showed the MT compression was greater than 75% in each case (mean 80.3% with a range of 75.7%-95%), and all patients were treated by decompressing the venous outflow obstruction by stenting the left common iliac vein, which relieved their symptoms. Venous compressions that occur on the anatomical left side can lead to right-sided symptoms. In patients reporting right-sided back and flank pain, MT should be considered in the differential diagnosis.
梅-图二氏（MT）综合征是指右髂总动脉对左髂总静脉的压迫。报告的症状通常为左侧腿部肿胀或疼痛。患者报告右侧症状并通过治疗MT压迫得以缓解的情况并不常见。本病例系列描述了三名因左侧静脉压迫而出现右侧症状的患者。一项回顾性病历审查确定了一年内出现各种症状（包括右腿疼痛和肿胀）并接受左侧静脉压迫治疗且症状得到缓解的三名患者。三名患者被确定有右侧背部和侧腹疼痛。血管造影联合血管内超声（IVUS）显示，每例患者的MT压迫均大于75%（平均80.3%，范围为75.7%-95%），所有患者均通过对左髂总静脉进行支架置入以解除静脉流出道梗阻进行治疗，症状得以缓解。发生在解剖学左侧的静脉压迫可导致右侧症状。在报告有右侧背部和侧腹疼痛的患者中，鉴别诊断时应考虑MT综合征。
