Dr. Kimmel Discusses May Thurner Syndrome
Recently, US Representative Lauren Boebert was diagnosed and treated for May Thurner Syndrome (MTS), a potentially serious venous condition in the leg. Here’s what you need to know.
MTS is an uncommon vascular condition in the pelvic area where the left sided iliac vein is compressed by the right-sided iliac artery. Some post-mortem studies found that up to 20% of people have this anatomical variant, but a much smaller percentage of people have an actual problem from it. If someone does have symptoms, it is usually left leg swelling, pain or blood clot formation. This condition is almost exclusively seen in women. In addition, some women develop pelvic pain and congestion. Most experts do not know exactly who will get this or why, as there has not been a proven link to family history or any type of inciting incident. Rather it is an anatomic variation.
The muscular, thicker-walled arteries bring blood from the heart to the rest of the body’s organs and muscles, then the thin-walled veins return the blood to the heart. When the left-sided iliac vein in the lower pelvic area crosses over to the vena cava to return blood to the heart, it must pass under the right-sided artery, and this is where compression of the vein can occur. The result of squeezing the vein is that the blood coming up from the left leg does not drain as well, and the blood could get backed up. This may give rise to swelling or blood clotting, as well as symptoms. (Think of an hourglass, where the mid-portion is narrow, as the area that is squeezed; or if on a large interstate highway, half the lanes are closed during rush hour, and the traffic backs up as drivers have to merge into the open lanes, then traffic backs up.)
Experienced vascular surgeons often consider a pelvic vascular problem when the patient presents with findings consistent with MTS. An ultrasound is usually the first test to order when this is suspected, but definitive treatment for symptomatic patients often includes placing a stent in the vein to help prevent the vein from being squeezed by the artery. Additional treatments for blood clots or leg vein problems may also be needed.
If you have leg swelling, pain, heaviness or other lower extremity symptoms, seek out an experienced and highly trained vascular specialist who is certified to manage venous problems. Dr Kimmel, a board-certified Cardiothoracic and Vascular Surgeon in Boca Raton, FL, has been in practice for over 30 years. Call The Kimmel Institute at (561)-477-0210 for your personal consultation.