May-Thurner Syndrome
May-Thurner Syndrome (MTS) is an uncommon anatomical condition affecting both men and women, typically diagnosed between ages 20 and 45. It leads to pronounced left leg swelling, pain, pressure, and a heavy feeling in the leg, and can cause serious issues such as Deep Vein Thrombosis (DVT) and Post-Thrombotic Syndrome. MTS occurs when the right iliac artery presses on the left iliac vein, hindering proper blood flow—much like two crossing vessels where one compresses the other.
Causes of May-Thurner Syndrome
MTS develops due to compression of the left iliac vein by the right common iliac artery. This restriction of venous blood flow from the lower body can result in leg pain, pressure, heaviness, and swelling.
Risk Factors & Symptoms of May-Thurner Syndrome
Risk Factors
• Being female
• Scoliosis
• Hysterectomy
• Pelvic surgery
• Anterior spine surgery
• Multiple pregnancies
• Oral contraceptive use
• Dehydration
• Conditions causing blood clotting
Symptoms:
Multiple risk factors significantly increase the likelihood of developing CAS, especially when three or more are present:
• Pain in the lower abdomen or pelvic region
• Varicose veins in the upper thigh of the left leg
• Swelling in the legs, often more pronounced on the left side
• Persistent pain, pressure, or heaviness that worsens throughout the day
• Chronic hemorrhoids
If you’re between 20 and 45 years old and experience any of these symptoms, promptly consult your medical provider.
Diagnosis of May-Thurner Syndrome
Several non-invasive tests can detect MTS, including a pelvic ultrasound, CT venogram, or intravascular ultrasound (IVUS). These help determine both the severity and complexity of the condition. In certain instances, short-term medical therapies may help relieve symptoms and lessen discomfort.
Treatment for May-Thurner Syndrome
An endovascular intervention is a minimally invasive approach often completed in an outpatient surgical setting. Guided by IVUS, a vascular surgeon locates the affected segments of the vein and places a stent to open it, restoring normal blood flow.
Prevention of May-Thurner Syndrome
You can potentially alleviate MTS symptoms with the following measures:
• Use compression socks/stockings to manage swelling
• Wear compression gear during extended or delayed travel
• Maintain a healthy weight and engage in daily exercise
• Take brief walks (5–10 minutes) every few hours if you sit or stand for extended periods
Disease Progression of May-Thurner Syndrome
If left untreated, MTS may advance through these stages:
1. Iliac Vein Compression – Some individuals may have minimal symptoms, though varicose veins may develop.
2. Venous Spur Formation – Fibrous “shelves” form in the vein, further restricting blood flow and raising the likelihood of DVT.
3. Deep Vein Thrombosis (DVT) – A blood clot develops inside the vein, severely limiting flow and causing significant leg pain and swelling.
FAQs About May-Thurner Syndrome:
Can May-Thurner Syndrome be cured?
Yes. Endovascular treatments can alleviate pain and discomfort, with most patients recovering quickly and returning to their routine activities. Ongoing check-ups with your provider are recommended.
Can May-Thurner Syndrome cause fatigue?
It can. Patients may also experience varicose veins and ulcers. If you feel fatigue—particularly when walking—contact your medical provider for an evaluation.
Does May-Thurner Syndrome cause back pain?
Some patients feel pain in the lower back or lower abdomen if the affected vein is in that region. This can occur alongside leg swelling, pressure, or heaviness. Any such symptoms should be evaluated by a healthcare professional.