A Comprehensive Review Article on May-Thurner or Cockett Syndrome
Keywords:Deep Vein Thrombosis, MTS, & Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis.
May-Thurner syndrome—it is also called iliocaval compression syndrome, Cockett syndrome or iliac vein
compression syndrome, which occurs secondary to compression of the left iliac vein by the overriding right
iliac artery. In the mid-19th century, it was observed that deep vein thrombosis was five times more prone
to occur in the left leg. Risk factors for MTS are Female gender, especially those who are postpartum,
multiparous, or using oral contraceptives.Clinical presentations of symptomatic MTS include, acute
extremity pain and swelling, venous claudication, or chronic development of symptoms/signs of venous
insufficiency. The diagnosis of May-Thurner Syndrome is based on the clinical presentation of left lower
extremity swelling and pain in association with radiologic evidence of compression. Doppler ultrasound
will identify if there is a DVT is present in the iliac vessels, but is unable to visualize iliac vein compression
and spurs.In the absence of DVT and for patients with only mild symptoms of left leg swelling or pain,
conservative measures of prevention are used, specifically, compression stockings. These are also used if the
severity of MTS requires more aggressive invasive interventions.
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