What is Iliac Vein Compression Syndrome?

Iliac Vein Compression Syndrome, also called May-Thurner Syndrome, is a natural condition that arises when the left common iliac vein is compressed between the right common iliac artery and the spine1. This leads to symptoms ranging from mild to serious, including leg pain, swelling, discoloration and iliofemoral vein DVT (deep vein thrombosis).

While the syndrome represents less than 5 percent of the currently diagnosed venous disorders, increased awareness and better diagnostic options are resulting in its more frequent identification as an underlying factor in venous disease. It is characteristically more common in women than men, and usually between the ages of 20 and 50 years old.

DiagnosisIliac_veins - medical model

The best way to identify the disorder is through intravascular ultrasound, but other tests, such as venous and interstitial pressure measurement, duplex ultrasound, venography and plethysmography, can aid in diagnosis2.

These diagnostic tests of the deep pelvic veins help physicians identify iliac vein compression syndrome. Patients that present with leg pain, swelling or discoloration should be tested, as well as those with varicose veins. If iliac vein compression syndrome underlies varicose veins, it should be treated first. Patients that have blood clots in the leg, or a history of such, should be tested for iliac vein compression syndrome. Proper diagnosis of this syndrome is important in helping physicians and patients selecting treatment options and preventing further, more debilitating, complications of venous disease.

Treatment

Some cases of iliac vein compression syndrome may require treatment, which will vary depending on the nature and severity of the patient’s symptoms. Treatments for minor cases include anti-clotting medication (anticoagulation) and compression therapy, such as compression stockings. If blood clots are present, thrombolytic therapy, which is the use of drugs to dissolve blood clots, may be necessary. In cases where the compression of the vein is serious, balloon angioplasty and stenting of the vein may be required3.

In all cases, if you suffer any of the symptoms discussed, you should consult a physician for proper diagnosis and care.

 

References:

1Raju S, Neglen P. High prevalence of nonthrombotic iliac vein lesions in chronic venous disease: a permissive role in pathogenicity. J Vasc Surg. 2006;44(1):136-43; discussion 144.

2Neglen P, Raju S.J. Intravascular ultrasound scan evaluation of the obstructed vein. J Vasc Surg. 2002;35(4):694-700.

3Fazel R, Froehlich JB, Williams DM, Saint S, Nallamothu BK. “Clinical problem-solving. A sinister development – a 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma”. N. Engl. J. Med. 2007;357(1):53-9.

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