Publications

May-Thurner Syndrome is characterized by compression of the left common iliac vein by the overlying right common iliac artery. The vein is compressed between the hard bony spine and the stiff pulsatile artery, resulting in venous thrombosis, collateral formation, and limb swelling. It is rarely associated with a concomitant ilio-iliac arteriovenous fistula (AVF). There are only a few reports of this rare combination, which poses significant diagnostic challenges and increases complication risks. We present the case of a 56-year-old woman with left leg swelling and pain due to May-Thurner syndrome and an associated AVF that was successfully treated with endovascular techniques.

Introduction

May-Thurner syndrome was first described by R. May and J. Thurner in 1957.1 It is seen most commonly in women in their third to fifth decades. Patients present with varying symptoms of venous hypertension, which leads to swelling of the left leg with or without deep vein thrombosis (DVT). Rarely, it is associated with an arteriovenous fistula (AVF) between the adjacent right iliac artery and the left iliac vein. It is important to properly diagnose the combination, as treatment success is very much dependent on it. Whether to treat both conditions or just one is based on the individual presentation. We present a similar rare combination in a 56-year-old woman who was successfully evaluated and treated with endovascular techniques.