A 42 yo female with history of extensive left lower extremity DVT treated with pharmacomechanical thrombolysis with good result returns to the clinic with persistent leg swelling and negative duplex ultrasound study. She underwent diagnostic venography with IVUS (intravascular ultrasound) which revealed May-Thurner Syndrome. This was treated with primary stenting with excellent technical and clinical result.
May-Thurner remains an underdiagnosed phenomenon which contributes to significant morbidity throughout the world. Some clinical clues include persistent swelling after successful catheter directed treatment of DVT, persistent swelling after Treatment of varicose veins, or concomitant deep and superficial venous insufficiency on venous Doppler ultrasound studies.
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