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      Miomas uterinos como causa poco frecuente de síndrome de compresión de vena iliaca Translated title: Uterine myomas as a rare cause of iliac vein compression syndrome

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          Abstract

          Resumen La compresión de la vena iliaca común izquierda suele producirse por el paso de la arteria iliaca común derecha (síndrome de May-Thurner), pero no debemos olvidar que hay otras causas que pueden producir estenosis de la misma. Presentamos dos casos de pacientes en las que la estenosis era secundaria a miomas uterinos y tras la flebografía de confirmación fueron derivadas a Ginecología para su tratamiento.

          Translated abstract

          Abstract Iliac compression syndrome (May-Thurner syndrome) is usually caused by pathologic compression of the left common iliac vein by the right common iliac artery, but we must not forget that there are other causes of stenosis. In these cases, two women suffered from stenosis secondary to myomas, and they were sent to Gynecology for their treatment after a diagnostic phlebography.

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          High prevalence of nonthrombotic iliac vein lesions in chronic venous disease: a permissive role in pathogenicity.

          Peter Neglén, S Raju (2006)
          Nonthrombotic iliac vein lesions (NIVL), such as webs and spurs described by May and Thurner, are commonly found in the asymptomatic general population. However, the clinical syndrome, variously known as May-Thurner syndrome, Cockett syndrome, or iliac vein compression syndrome, is thought to be a relatively rare contributor of chronic venous disease (CVD), predominantly affecting the left lower extremity of young women. The present study describes the much broader disease profile that has emerged with the use of intravascular ultrasound (IVUS) scanning for diagnosis and analyzes stent placement outcome in two specific NIVL subsets that may offer clues to their pathogenic role. Among 4026 patients with CVD symptoms spanning the range of CEAP clinical classes, IVUS examinations were selectively done in severely symptomatic patients for indications as described. Iliac vein obstructive lesions were found in 938 limbs of 879 patients; 53% of the limbs had NIVL, 40% were post-thrombotic, and 7% were a combination. Stents were placed in 332 limbs in 319 patients in two NIVL subsets. The subsets, one with and one without associated distal limb reflux, were compared. Reflux was left untreated in the first subset. The median age was 54 years (range, 18 to 90 years). The female-male ratio was 4:1 and the left-right ratio was 3:1. NIVL lesions in the iliac vein occurred at the iliac artery crossing (proximal lesion) and also at the hypogastric artery crossing (distal lesion), a new IVUS finding. Venography was only 66% sensitive, with 34% of venograms appearing "normal." IVUS had a diagnostic sensitivity of >90%. The cumulative results observed at 2.5 years after stent placement in the NIVL subsets with reflux and without reflux, respectively, were complete relief of pain 82% and 77%, complete relief of swelling 47% and 53%, complete stasis ulcer healing 67% and 76%, and overall clinical relief outcome 75% and 79%. These results are nearly identical between the two subsets even though distal reflux remained uncorrected in the NIVL plus reflux subset. NIVL has high prevalence and a broad demographic spectrum in patients with CVD. Similar lesions in the asymptomatic general population may be permissive of future development of CVD. Stent placement alone, without correction of associated reflux, often provides relief.
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            Iliac vein compression syndrome: Clinical, imaging and pathologic findings.

            Katelyn Brinegar, Rahul Sheth, Ali Khademhosseini … (2015)
            May-Thurner syndrome (MTS) is the pathologic compression of the left common iliac vein by the right common iliac artery, resulting in left lower extremity pain, swelling, and deep venous thrombosis. Though this syndrome was first described in 1851, there are currently no standardized criteria to establish the diagnosis of MTS. Since MTS is treated by a wide array of specialties, including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate treatment. Although MTS has historically been diagnosed by the presence of pathologic features, the use of dynamic imaging techniques has led to a more radiologic based diagnosis. Thus, imaging plays an integral part in screening patients for MTS, and the utility of a wide array of imaging modalities has been evaluated. Here, we summarize the historical aspects of the clinical features of this syndrome. We then provide a comprehensive assessment of the literature on the efficacy of imaging tools available to diagnose MTS. Lastly, we provide clinical pearls and recommendations to aid physicians in diagnosing the syndrome through the use of provocative measures.
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              Systematic review of May-Thurner syndrome with emphasis on gender differences

              Alan Dardik, Cassius Iyad Ochoa Chaar, Timur Sarac … (2018)
              May-Thurner syndrome (MTS) is increasingly recognized as a frequent source of leg swelling and a precipitating factor for venous thromboembolism. This paper is a systematic review of the English literature on MTS with an analysis focusing on gender differences in presentation and treatment.
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                Author and article information

                Journal
                Journal ID (publisher-id): angiologia
                Title: Angiología
                Abbreviated Title: Angiología
                Publisher: Arán Ediciones S.L. (Madrid, Madrid, Spain )
                ISSN (Print): 0003-3170
                ISSN (Electronic): 1695-2987
                Publication date (Print and electronic): October 2021
                Volume: 73
                Issue: 5
                Pages: 256-259
                Affiliations
                [2] Madrid orgnameHM Puerta del Sur España
                [1] Madrid orgnameHospital Universitario HM Montepríncipe orgdiv1Centro Integral de Enfermedades Cardiovasculares (CIEC) orgdiv2Servicio de Angiología, Cirugía Vascular y Endovascular Spain
                Article
                Publisher ID: S0003-31702021000500008 Publisher ID: S0003-3170(21)07300500008
                DOI: 10.20960/angiologia.00311
                SO-VID: 755b2e15-b650-46e5-b26d-e5f9103804d8
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                Date received : 08 April 2021
                Date accepted : 23 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Spain

                Categories
                Subject: Casos Clínicos

                Keywords: Extrinsic,Myomas,May-Thurner syndrome,Iliac compression,Extrínseco,Miomas,Síndrome May-Thurner,Compresión iliaca
                Data availability:
                Keywords: Extrinsic, Myomas, May-Thurner syndrome, Iliac compression, Extrínseco, Miomas, Síndrome May-Thurner, Compresión iliaca

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