Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492011000100014
Jornal Vascular Brasileiro
Case Report

Tratamento endovascular da síndrome de compressão da veia ilíaca (May-Thurner): relato de caso

Endovascular treatment of iliac vein compression syndrome (May-Thurner): a case report

Jorge Ribeiro da Cunha Júnior; Daniel Queiroz Neves; Fernando Azambuja Fontes; Gustavo Petorossi Solano; Marcio Cerbazzi Tavares Cardoso; Mauro Henrique de Lima; Irlandia Figueira Ocke Reis; Paulo Eduardo Ocke Reis

http://dx.doi.org/10.1590/S1677-54492011000100014 J Vasc Bras, vol.10, n1, p.72-76, 2011
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Resumo

A Síndrome de May-Thurner é uma causa pouco comum de sinais e sintomas venosos relacionados ao membro inferior esquerdo. Esta síndrome é caracterizada pela compressão da veia ilíaca comum esquerda pela artéria ilíaca comum direita e, quando tal alteração anatômica causa sintomas que venham a prejudicar a qualidade de vida do paciente, existe a indicação de tratamento cirúrgico ou endovascular para correção desta alteração anatômica. Este artigo é o relato de um caso, no qual optou-se pelo tratamento endovascular com resultado satisfatório e as indicações, as nuances e os resultados esperados para esta técnica no tratamento da Síndrome de May-Thurner são discutidos. Foi concluído que, nesta síndrome, há eficácia do tratamento endovascular com melhora dos sintomas pela recanalização do sistema venoso, sem grandes riscos inerentes ao procedimento e com curto período de internação hospitalar.

Palavras-chave

veia ilíaca, artéria ilíaca, varizes, edema, flebografia

Abstract

May-Thurner Syndrome is an uncommon cause of venous symptoms and signs related to the left lower limb. It is characterized by compression of the left common iliac vein by the right common iliac artery and, when such anatomical change causes symptoms that may impair the patients' quality of life, surgical treatment is indicated. This article addresses a case of May-Thurner syndrome in which we opted for endovascular treatment with satisfactory outcome, as well as a discussion about indications, nuances, and expected results. We concluded that endovascular treatment is effective in treating this syndrome, for it resolves the symptoms by recanalization of the venous system with little risks during the procedure and with short hospital stay.

Keywords

iliac vein, iliac artery, varicose veins, edema, phlebography

References

Mickley V, Schwagierek R, Rilinger N. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation. J Vasc Surg. 1998;28:492-7.

Heniford BT, Seyhan SO, Olsofka JM. May-Thurner syndrome: management by endovascular surgical techniques. Ann Vasc Surg. 1998;12:482-6.

O'Sullivan GJ, Semba CP, Bittner CA. Endovascular management of iliac vein compression syndrome. J Vasc Interv Radiol. 2000;11:823-36.

May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419-27.

Cockett FB, Thomas ML. The iliac compression syndrome. Br J Surg. 1965;52:816-21.

Halliday P, Harris J, May J. Femoro-femoral crossover grafts (Palma operation): a long term follow-up study. Surgery of the Veins. 1985:241-54.

Patel NH, Stookey KR, Ketcham DB. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome. J Vasc Interv Radiol. 2000;11:1297-302.

Grunwald M, Goldberg M, Hoffman L. Endovascular management of May-Thurner syndrome. AJR. 2004;183:1523-4.

Jeon UB, Chung JW, Jae HJ. May-Thurner syndrome complicated by acute iliofemoral vein thrombosis: helical CT venography for evaluation of long-term stent patency and changes in the iliac vein. AJR Am J Roentgenol. 2010;195(3):751-7.

Thomas M, Fletcher W, Cockett . Venous collaterals in external and common iliac vein obstruction. Clin Radiol. 1967;18:403-11.

Dhillon RK, Stead LG. Acute deep vein thrombus due to May-Thurner syndrome. Am J Emerg Med. 2010;28(2):254.e3-4.

Oderich G, Treiman G, Schneider P. Stent placement for treatment of central and peripheral venous obstruction: a long-term multi-institutional experience. J Vasc Surg. 2000;32:760-9.

Lamont JP, Pearl GJ, Patetsios P. Prospective evaluation of endoluminal venous stents in the treatment of the May-Thurner syndrome. Ann Vasc Surg. 2002;16:61-4.

Kibbe M, Ujiki M, Goodwin A. Iliac vein compression in an asymptomatic patient population. J Vasc Surg. 2004;39:937-43.

Taheri SA, Williams J, Powell S. Iliocaval compression syndrome. Am J Surg. 1987;154:169-72.

Nazarian GK, Austin WR, Wegryn SA. Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: fouryear experience. Cardiovasc Intervent Radiol. 1996;19:227-33.

Akesson H, Brudin L, Dahlstrom JA. Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation. Eur J Vasc Surg. 1990;4:43-8.

Gruss JD, Hiemer W. Bypass procedures for venous obstruction. Surgical Management of Venous Disorders. 1997:289-305.

Raffini L, Raybagkar D, Cahill A. May-Thurner syndrome (iliac vein compression) and thrombosis in adolescents. Pediatr Blood Cancer. 2006;47:834-8.

Baron HC, Shams J, Wayne M. Iliac vein compression syndrome: a new method of treatment. Am Surg. 2000;66:653-5.

França LHG, Tavares V. Insuficiência venosa crônica: Uma atualização. J Vasc Br. 2003;2(4):318-28.

Neglen P, Berry MA, Raju S. Endovascular surgery in the treatment of chronic primary and post-thrombotic iliac vein obstruction. Eur J Vasc Endovasc Surg. 2000;20:560-71.

Sandri JL. Síndrome de May-Thurner-Tratamento Endovascular. Cirurgia Vascular. 2007:1653-64.

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