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      Iliac Vein Compression Syndrome in an Active and Healthy Young Female

      case-report

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          Abstract

          Iliac vein compression syndrome is a condition involving external compression of the left common iliac vein by the right iliac artery, which was first described in the 1850s. It predominates in females typically between the third and fourth decade of life and has been associated with thrombophilias. Importantly, the syndrome is amenable to endovascular treatment. Here, we describe a case of a young athletic female with an incidental finding of a left iliac vein thrombosis while taking oral contraceptives, who was identified as having iliac vein compression syndrome on follow-up MR venography with positive testing for Factor V Leiden mutation.

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          The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins.

          Philipp J. Thurner, Bennett May (1957)
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            Iliac vein compression in an asymptomatic patient population.

            Michael B. Ujiki, James C Yao, Victoria Goodwin … (2004)
            May-Thurner syndrome is a well-recognized anatomic variant that is associated with the development of symptomatic acute venous thrombosis of the left iliac vein. However, the natural frequency of compression of the left iliac vein and its clinical significance in asymptomatic disease has not been established. Therefore the purpose of this descriptive anatomic study was to determine the incidence of left common iliac vein compression in an asymptomatic population. A retrospective analysis of medical records and helical abdominal computed tomography scans was conducted in 50 consecutive patients evaluated in the emergency department because of abdominal pain. Medical records were reviewed for symptoms and risk factors for deep venous thrombosis, and data were collected and reported according to the Joint Society Reporting Standards for acute lower extremity venous thrombosis. All computed tomography was performed with intravenous contrast medium, and 2-mm to 5-mm axial images were obtained. The minor diameter of the common iliac arteries and veins was measured. The technique of transverse image measurement was validated with multiplanar reconstructions and orthogonal diameter measurements in a subset of subjects. Statistical analysis was performed with the Student t test or Spearman rank correlation. Mean age of subjects without symptoms was 40 years (range, 19-85 years), and 60% (n = 30) were female patients. The mean acute lower extremity venous thrombosis risk factor score was 1.16 +/- 0.23 (range, 0-6; maximum possible score, 28). It was surprising that 24% (n = 12) of patients had greater than 50% compression and 66% (n = 33) had greater than 25% compression. Mean compression of the left common iliac vein was 35.5% (range, -5.6%-74.8%). The structure most often compressing the left common iliac vein against the vertebral body was the right common iliac artery (84%). There was no strong correlation between patient age or common iliac artery size and compression of the left common iliac vein. However, women had greater mean compression of the left common iliac vein (women, 41.2% +/- 3.1%; men, 27.0% +/- 3.0%; P =.003). Hemodynamically significant left common iliac vein compression is a frequent anatomic variant in asymptomatic individuals. Therefore compression of the left iliac vein may represent a normal anatomic pattern that has thus far been thought of as a pathologic condition.
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              Oral contraceptives and the risk of venous thrombosis.

              Frans Helmerhorst, J Rosing, Jan P. Vandenbroucke … (2001)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Report Med
                Journal ID (publisher-id): CRIM
                Title: Case Reports in Medicine
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 1687-9627
                ISSN (Electronic): 1687-9635
                Publication date (Print): 2012
                Publication date (Electronic): 14 February 2012
                Volume: 2012
                Electronic Location Identifier: 786876
                Affiliations
                1Department of Medicine, Foothills Medical Hospital, Calgary, AB, Canada T2N 2T9
                2Department of Radiology, Foothills Medical Hospital, Calgary, AB, Canada T2N 2T9
                Author notes

                Academic Editor: Omer Faruk Dogan

                Article
                DOI: 10.1155/2012/786876
                PMC ID: 3295563
                PubMed ID: 22431940
                SO-VID: 5cb0202f-27d0-4dd2-ad8d-4b49e8e31a5f
                Copyright © Copyright © 2012 Sonia Cerquozzi et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 29 June 2011
                Date accepted : 24 November 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
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                ScienceOpen disciplines: Medicine

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