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May-Thurner Syndrome: Understanding Your Treatment Options

May-Thurner Syndrome: Understanding Your Treatment Options

Ongoing swelling in your lower left leg, with or without leg pain, is a sure sign you need a thorough vascular checkup.

Leg swelling is a common sign of many blood vessel problems, including May-Thurner syndrome (MTS), a condition that blocks left leg circulation and puts you at risk of serious complications like deep vein thrombosis.

At Memphis Vein Center, vascular expert Kishore K. Arcot, MD, FACC, has helped many patients overcome MTS, providing advanced treatments that restore healthy veins and relieve symptoms. Here, he gives you a rundown of the top treatment options for MTS.

May-Thurner syndrome explained

MTS occurs when the iliac vein carrying blood out of your left leg becomes pinched. The left iliac vein crosses paths with another blood vessel, the right iliac artery, in your lower pelvic area.

The vein gets pinched if the artery pushes it, compressing the vein against the nearby vertebra. As a result, blood flow through the vein slows down, forcing blood to back up in the leg vein.

The top symptoms of MTS include pelvic pain and left leg swelling and pain, but you may have other symptoms if MTS causes one of the following complications:

Deep vein thrombosis (DVT)

The sluggish blood flow that MTS causes significantly increases your risk of blood clots and DVT, a clot in a vein in the center of your leg.

DVT may not cause symptoms, but if it does, you’ll experience:

A DVT can turn into a life-threatening condition if the clot breaks away, flows through your bloodstream, and reaches your lungs.

Once inside a lung, the clot can block blood flow, causing a pulmonary embolism and symptoms such as chest pain, shortness of breath, coughing, and dizziness.

A pulmonary embolism is a medical emergency needing immediate treatment to prevent a cardiac arrest (when your heart suddenly stops).

Chronic venous insufficiency

As blood accumulates in the vein, blood pressure in the lower leg veins increases. The increased pressure can damage valves, allowing blood to back up in your lower leg.

Chronic venous insufficiency leads to varicose veins and conditions in your lower leg, including skin rashes, thick and discolored skin, and non-healing leg ulcers.

MTS treatment options

Our first goal is restoring healthy circulation through the left iliac vein. Although you may only need MTS treatment, we also treat any accompanying conditions, including chronic venous insufficiency, DVT, and leg ulcers.

The possible treatments for MTS and DVT include:

Angioplasty and stenting

Angioplasty and stenting is a minimally invasive procedure to reopen the vein. We make a tiny cut and use real-time imaging to guide a catheter into and through the blood vessel.

When the catheter reaches the blocked area in the left iliac vein, we deploy and inflate a balloon, which opens the vein. Finally, we implant a stent, a metal mesh cylinder that stays in the vein and keeps it open.

This procedure immediately restores blood flow, easing leg pain and swelling and preventing complications.

Medication for blood clots

If diagnostic imaging reveals blood clots or DVT, we may prescribe two types of medications. Blood thinners (anticoagulants) improve blood flow, prevent new clots from forming, and stop existing clots from getting bigger.

You may need a clot-busting medication (thrombolytic drug) to dissolve large clots or treat DVT. We deliver the medication through a catheter inside the vein, releasing it at the clot for optimal results.

Thrombectomy or bypass

If a blood clot doesn’t improve with medication or you can’t take thrombolytic drugs due to a medical condition, we may need to perform a thrombectomy to remove the clot. We usually use a catheter to do the thrombectomy from inside the vein.

In rare cases of severe MTS, or if the condition returns despite angioplasty and stenting, we may surgically bypass the pinched area.

Seek early treatment

Pelvic pain alone can be confusing and may not mean you have MTS, because many health concerns cause lower abdominal pain. 

But pelvic pain with leg symptoms or leg symptoms alone (pain, swelling, heaviness, itching, skin changes, and open sores) are red flags for vascular problems like MTS.

Use online booking or call our office if you have concerns or questions about symptoms or need exceptional care for MTS. Early treatment to improve circulation eases your symptoms and prevents potential complications.

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