PRIMARY MAY-THURNER SYNDROME, CLINICAL AND ENDOVASCULAR SURGICAL RESULTS. OUR EXPERIENCE.

  • Miguel Machado Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto
  • Rui Machado Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto; Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Daniel Mendes Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Rui Almeida Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto; Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
Keywords: May-Thurner Syndrome, Cockett Syndrome, Non Thrombotic Iliac Vein Obstruction Syndrome, iliocaval stenting

Abstract

Objective: To evaluate the experience on endovascular treatment of primary May-Thurner Syndrome (MTS)

Introduction: Primary May-Thurner Syndrome, results from the compression of the left common iliac vein by the right common iliac artery and the 5fth vertebral body.

Methods and material: Retrospective analysis based on the clinical and imagiological records related to 21 patients diagnosed with non complicated May-Thurner Syndrome who underwent endovascular surgical treatment. The SPSS statistic 21 IBM was used to do a uni and bivariated descriptive analysis as so as the realization of the hypothesis test.

Results: The mean age was 44 years old, and 90% were female,with two peaks of incidence: one during the third decade of life, and the other during the fifth and sixth decades. The most common symptom was left inferior limb edema (85%), the mean time between the beginning of the symptoms and the diagnosis was 5,05 years and the treatment was primary stenting in 90,5% of the cases. With a mean follow-up of 54,43 months, the primary patency was 85,7% and the primary assisted patency was 100%. All patients submitted to angioplasty alone necessitate a stenting posteriorly. On the sixteen patients that were classified by the Venous Clinical Severity Score (VCSS), it was shown a statistically significant improvement on the post-operatory scores related to pain, the left inferior limb edema and the global score. There was a significant correlation between the time between the beginning of symptoms and diagnosis ,and the post-operatory edema score.

Discussion/Conclusion: An assisted primary patency of 100% was observed according to the published literature. The delayed diagnosis of the MTS may correspond to the lack of clinical knowledge and was associated with poor results.

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Published
2018-12-02
Section
Original Article