May-Thurner Syndrome

This single-center, retrospective review identified 6 patients (n = 6, 100% female) treated by endovascular therapy for May-Thurner syndrome from June 2013 to September 2015. Patients consisted of 3 African American, 2 Caucasian and 1 Asian; mean age was 53.50 +/- 8.31 years, range: 39-63 years. Clinical presentations consisted of left lower extremity deep vein thrombosis in 4, left lower extremity deep vein thrombosis with pulmonary embolism in 1 and pulmonary embolism with left common iliac vein thrombosis in 1 patient. All 6 patients were treated with catheter-directed thrombolysis and venous stenting to correct the underlying anatomical defect. Hypercoagulability work up revealed antiphospholipid antibody syndrome in 1 patient. No major periprocedural complications were observed. Median follow-up period was 22 +/- 5.5 months (range: 13-30 months). One patient with pre-exiting antiphospholipid antibody syndrome developed stent thrombosis with secondary loss of patency. Endovascular therapy for May-Thurner syndrome in our adult cohort seemed safe and effective. One patient with pre-existing thrombophilia developed secondary loss of stent patency, suggesting need for further investigation in this subgroup.