May-Thurner Syndrome (MTS), also known as iliocaval compression syndrome, is a vascular condition that affects the veins in the pelvic region, specifically where the left iliac vein passes under the right iliac artery.

This anatomical quirk can lead to compression of the vein, causing a range of symptoms and potential complications.


Causes and Mechanism

MTS typically occurs when the left iliac vein becomes compressed by the overlying right iliac artery. This compression can result in narrowing of the vein, leading to reduced blood flow and potential formation of blood clots. The exact cause of this anatomical compression can vary, but it’s often due to the natural positioning of these vessels relative to each other.

May Thurner Syndrome Symptoms

Symptoms of May-Thurner Syndrome can vary widely but often include:

  • Leg pain or swelling: Due to impaired blood flow, patients may experience pain, heaviness, or swelling in the left leg, sometimes accompanied by visible varicose veins.
  • Deep vein thrombosis (DVT): The narrowing of the iliac vein can increase the risk of blood clot formation, particularly in the left leg.
  • Chronic venous insufficiency: Over time, inadequate blood flow can lead to skin discoloration, ulcers, and other complications associated with venous insufficiency.

Misdiagnosis and Differential Diagnosis

MTS is often misdiagnosed or confused with other conditions such as deep vein thrombosis (DVT), iliac vein compression syndrome, or chronic venous insufficiency. Proper diagnosis requires a thorough evaluation by a vascular specialist, often involving ultrasound imaging or more advanced diagnostic techniques to assess blood flow and vein structure.

May Thurner Syndrome Treatment Options

Treatment for May-Thurner Syndrome aims to relieve the compression of the left iliac vein and improve blood flow. Depending on the severity of the condition and individual patient factors, treatment options may include:

  • Anticoagulant therapy: To prevent or dissolve blood clots.
  • Angioplasty and stenting: A minimally invasive procedure to widen the narrowed vein and keep it open with a stent.
  • Surgical bypass: In cases where other treatments are not feasible or effective, surgical bypass may be considered to reroute blood flow around the compressed area.

Origin of the Name

May-Thurner Syndrome is named after the two physicians who first described it in 1957: Drs. May and Thurner. They identified the anatomical anomaly and its clinical implications, laying the foundation for further research and understanding of this condition.

Understanding May-Thurner Syndrome is crucial for recognizing its symptoms and seeking appropriate treatment. If you experience persistent leg pain, swelling, or other signs of venous insufficiency, consulting with a vein specialist is essential for accurate diagnosis and personalized treatment options.


At Vein Specialists of the Carolinas, we are dedicated to providing comprehensive care for vascular conditions like May-Thurner Syndrome. Contact us today to schedule a consultation and learn more about how we can help you achieve healthier veins.

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