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Suggest Treatment For May–Thurner Syndrome
Question: the right common lilac artery sits over the left common lilac vein although i can identify a normal calibre right common lilac vein the left common. lilac vein is not identified and presumably occluded in the region of the extemal lilac vein there is once again some venous structures suggestive that there may be some recanalised flow in this region there appears to be chronic occlusion with non visualisation of the left common lilac vein presumably as part of the may-turner stndrome and the vein changes could be further assessed with a ct venogram or alternatively a venous duplex study.Thanks
Brief Answer:
Treatment required only if severely symptomatic.
Detailed Answer:
Hello,
Welcome to Health Care Magic and Thanks for your question.
May Thurner syndrome is the definite diagnosis for what you explain.
The question is who is the patient and what problems do he or she have.
If there is no significant problem then nothing should be done. At our Vascular Surgery Center where I work we do intervention only if the patient has symptoms of massive limb swelling, pain or ulceration at the leg or ankle. Otherwise we advice just compression stockings as these veins do get collateralised and flow continues through other venous channels.
If treatment is desired then a Venogram can be done followed by a Stenting of the area of the Stenosis or occlusion of the vein. Also depends as to how long back the problem started.
Therefore do let me know patient details in order for me to comment more in detail.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, New XXXXXXX XXXXXXX
Treatment required only if severely symptomatic.
Detailed Answer:
Hello,
Welcome to Health Care Magic and Thanks for your question.
May Thurner syndrome is the definite diagnosis for what you explain.
The question is who is the patient and what problems do he or she have.
If there is no significant problem then nothing should be done. At our Vascular Surgery Center where I work we do intervention only if the patient has symptoms of massive limb swelling, pain or ulceration at the leg or ankle. Otherwise we advice just compression stockings as these veins do get collateralised and flow continues through other venous channels.
If treatment is desired then a Venogram can be done followed by a Stenting of the area of the Stenosis or occlusion of the vein. Also depends as to how long back the problem started.
Therefore do let me know patient details in order for me to comment more in detail.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, New XXXXXXX XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi I had before The clots they done for me ct scan for the clots but i want to know it's still there?Hi what is means? the right common lilac artery sits over the left common lilac vein although i can identify a normal calibre right common lilac vein the left common. lilac vein is not identified and presumably occluded in the region of the external iliac vein there is once again some venous structures suggestive that there may be some recanalized flow in this region there appears to be chronic occlusion with non visualisation of the left common lilac vein presumably as part of the may XXXXXXX sydrome and the lilac vein changes could be further assessed with a ct venogram or alternatively a venous duple stud
Brief Answer:
No more investigations are required.
Detailed Answer:
Hi,
Thanks for the answer.
The study is right. In May Thurner syndrome the Left iliac vein is compressed by the Right Iliac artery and can lead to occlusion of the said vein. This then leads to limb swelling and other problems. But over a period of time other veins take up the job of the Left ilaic vein and the patient comes back to normal. That is the normal course of this condition and there is no need to worry about it. If you are comfortable now, nothing more needs to be done. not even Doppler or CT Venogram. These investigations will only show the problem better but not help in treatment.
You should continue to be on Tab Aspirin 75mg once a day and Tab Daflon 500mg twice a day for three months at least. Aspirin should be continued for 5 years. And you would stay fine.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, XXXXXXX
No more investigations are required.
Detailed Answer:
Hi,
Thanks for the answer.
The study is right. In May Thurner syndrome the Left iliac vein is compressed by the Right Iliac artery and can lead to occlusion of the said vein. This then leads to limb swelling and other problems. But over a period of time other veins take up the job of the Left ilaic vein and the patient comes back to normal. That is the normal course of this condition and there is no need to worry about it. If you are comfortable now, nothing more needs to be done. not even Doppler or CT Venogram. These investigations will only show the problem better but not help in treatment.
You should continue to be on Tab Aspirin 75mg once a day and Tab Daflon 500mg twice a day for three months at least. Aspirin should be continued for 5 years. And you would stay fine.
Take care and do let me know if there are other queries on this issue.
Dr Rishi, XXXXXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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