Surgical anteriorization of the left common iliac vein results in improved venous outflow and quality of life for May-Thurner syndrome

May-Thurner syndrome or left iliac vein compression occurs when the left common iliac vein is compressed by the right common iliac artery, leading to venous out fl ow obstruction. This obstruction can cause venous hypertension, resulting in lower extremity swelling, discoloration, pelvic congestion, and venous ulcerations. The standard surgical treatment of May-Thurner syndrome is endovascular venous stent placement. In a small, single -center sample, surgical anteriorization of the left common iliac vein was used to treat symptomatic left common iliac vein compression in younger patients, alleviating their symptoms, and can be considered an alternative treatment. (J Vasc Surg Cases Innov Tech 2024;10:101495.)