May-Thurner Syndrome: Causes, Symptoms, and Treatments

May-Thurner Syndrome

May-Thurner Syndrome, also known as iliac vein compression syndrome, is a health problem that arises when the left iliac vein, becomes compressed by the right iliac artery against the spine. This article will explore the risk factors, signs and symptoms, diagnosis, treatment options, and frequently asked questions about May-Thurner Syndrome (MTS).

Causes of May-Thurner Syndrome

May-Thurner Syndrome is caused by the anatomical variation of the iliac vessels, which increases the risk of iliac vein compression, leading to potential complications. The left iliac vein typically passes under the right iliac artery, and when this anatomical relationship is altered, compression can occur, potentially affecting the flow of blood.

The exact reasons for this variation are not fully understood, but it is believed to be influenced by genetic factors, which may result in symptoms like pelvic pain, back pain, varicose veins of the legs, leg swelling and more. In cases of severe compression, there are minimally invasive treatment options, such as stent placement that can alleviate the symptoms of the condition.

Symptoms of May-Thurner Syndrome

MTS often presents a range of symptoms, which can vary in severity from person to person. Some common symptoms associated with the condition include:

Leg Pain: May-Thurner Syndrome worsens with activity and extended sitting or standing.

Leg Swelling: Common symptom of May-Thurner Syndrome, caused by impaired blood flow and fluid buildup in the affected area.

Varicose Veins: May-Thurner Syndrome can lead to visible varicose veins, which are enlarged and twisted veins.

Deep Vein Thrombosis (DVT): May-Thurner Syndrome increases the risk of deep vein thrombosis (DVT), which means blood clots in the leg’s deep veins.

Pelvic Pain: Some patients may experience pelvic pain due to the compression of the iliac vein in the pelvic region.


Diagnosis of May-Thurner Syndrome

Diagnosing May-Thurner Syndrome requires a thorough evaluation of the patient’s medical history, a physical examination, and various imaging tests. Some of the commonly used diagnostic methods include:

Ultrasound: Ultrasound imaging is often the initial diagnostic tool used to visualize the blood flow in the affected area. It can help identify blood clots, vein compression, and other abnormalities.

Venography: It involves injecting a contrast dye into the veins and taking X-rays to check blood flow and spot blockages or compressions.

Magnetic Resonance Imaging (MRI): MRI provides detailed images of the blood vessels and surrounding structures, helping in the diagnosis of May-Thurner Syndrome.


Treatment Options for May-Thurner Syndrome

Treatment for May-Thurner Syndrome aims to enhance blood flow, relieve symptoms, and prevent complications like deep vein thrombosis and pulmonary embolism. Treatment methods vary based on condition severity and the patient’s overall health. Common approaches include:

Angioplasty and Stenting: Angioplasty is a minimally invasive procedure where a small balloon is inserted into the compressed vein and inflated to widen the narrowed area. In some cases, a stent, a small mesh-like tube, may be placed in the vein to keep it open and improve blood flow.

Compression Stockings: Compression stockings are elastic garments worn on the legs to apply pressure and improve blood flow. They can help reduce swelling and alleviate leg pain associated with May-Thurner Syndrome.

Blood-Thinning Medications: Anticoagulant medications, commonly known as blood thinners, are often prescribed to prevent the formation of blood clots and reduce the risk of deep vein thrombosis. These medications do not dissolve existing clots but can prevent them from growing larger and new ones from forming.



May-Thurner Syndrome is a vascular disorder that can lead to significant discomfort and potential complications if left untreated. It is essential to recognize the symptoms and seek medical attention promptly to prevent the progression of the condition and reduce the risk of serious consequences such as deep vein thrombosis and pulmonary embolism. With advances in diagnostic and treatment options, patients with May-Thurner Syndrome can lead a better quality of life with improved blood flow and symptom management.



Are there any long-term complications associated with May-Thurner Syndrome?
Yes, if left untreated, May-Thurner Syndrome can lead to long-term complications such as chronic leg pain, persistent swelling, skin changes, and even ulcers in severe cases. Additionally, the risk of developing blood clots and related complications such as pulmonary embolism are a top concern.

Is May-Thurner Syndrome more common in certain demographics?
Yes, May-Thurner Syndrome is more commonly seen in women, and it is believed that hormonal factors may play a role in its development. The condition is more prevalent in individuals between the ages of 20 and 50. Many women post pregnancy discover they are afflicted with May-Thurner Syndrome (MTS).