Your Trusted Deep Vein Thrombosis & May-Thurner SyndromeTreatment and Prevention Experts In South Dakota
What is Deep Vein Thrombosis & May-Thurner Syndrome
May-Thurner syndrome, or iliac vein compression syndrome, is an anatomical anomaly where the right iliac artery puts pressure on the left iliac vein. This compression increases the risk of developing a deep vein thrombosis (DVT) in the left leg. Deep vein thrombosis (DVT) occurs when a blood clot forms in one of the deep veins in the legs, pelvis, and less commonly the upper extremities. Many of these clots are small and patients may not develop symptoms. When the clots are large, however, they may cause leg pain, discoloration, and swelling.
Symptoms of Deep Vein Thrombosis & May-Thurner Syndrome
The most common symptoms of deep vein thrombosis include:
- Leg swelling
- Pain or cramping in the leg or calf
- Red or purple color changes
- Warm feeling in the leg
Causes of Deep Vein Thrombosis & May-Thurner Syndrome
May-Thurner Syndrome (MTS) typically causes multiple DVT, with patients often returning for procedures to remove blood clots in the pelvis. MTS is under-diagnosed and is caused by an artery in the pelvis that compresses or narrows the underlying vein, resulting in slow flow and a higher likelihood of causing DVT.
The most common cause of DVT is prolonged immobility, such as long car or plane rides, or prolonged bedrest after recent surgery.
If patients have an underlying clotting or inflammatory disorder, they may be vulnerable to developing DVT.
If a clot in the leg or pelvis breaks loose, they may migrate through the bloodstream into the lungs causing pulmonary embolism (PE). This may cause significant shortness of breath, chest pain, palpitations, dizziness, or fainting.
Risk Factors of Deep Vein Thrombosis & May-Thurner Syndrome
One or more of the following things can increase the risk of DVT:
Smoking
Prior blood clots/ Genetic Clotting
Sedentary or inactive lifestyle
Obesity
Birth Control Pills
Hormone replacement therapy
Inflammatory bowel Disease
Cancer
Pregnancy or recent birth
Recent surgery
Diagnosis of Deep Vein Thrombosis & May-Thurner Syndrome
To diagnose DVT, a physician will take a medical history and perform a physical examination. Additional testing may include:
- Blood testing. This will likely include a D-dimer test to look for high levels of proteins released into the blood when blood clots form.
- Ultrasound. A technician will likely perform a simple non-invasive scan of your legs or arms to look for blood clots.
- CT Venography. A CT scan of the veins in your legs and pelvis may be required to determine the site of blood clot formation.
- Angiography. A physician may perform a safe, minimally invasive procedure to diagnose and treat DVT in the pelvis or lower extremities. During this procedure, the clots are usually removed to restore normal blood flow.
Treatment of Deep Vein Thrombosis & May-Thurner Syndrome
Blood thinners form the mainstay of therapy for DVT. Depending on the location and size of DVT, additional procedures may be recommended.
Blood thinners like Rivaroxaban (Xarelto), Apixaban (Eliquis), or warfarin (Jantoven, Coumadin) will likely be prescribed to treat and prevent DVT.
Thrombolytics, also known as clot busting medications, may be required in rare cases.
If the clots are large, you may be offered thrombectomy, where an interventional cardiologist will remove the clots to restore normal blood flow.
Vein stenting to keep veins open may be required, especially in May-Thurner Syndrome (MTS). The most commonly used and approved venous stent is the Medtronic Abre self-expanding stent.
Associated Complications of Deep Vein Thrombosis & May-Thurner Syndrome
Pulmonary Embolism (PE): If a DVT breaks loose and travels to the lungs this is called a pulmonary embolism. It may cause severe symptoms such as shortness of breath, coughing up blood, chest pain, rapid heartbeat, dizziness or fainting. If you have these symptoms call 911.
Postphlebitic Syndrome: DVT can damage veins in the legs making them incompetent or “leaky.” It can result in color changes, pain, swelling, and open wounds or sores. This can be treated by cardiologists. If you were diagnosed with DVT by another physician, blood thinners alone may not dissolve the clot or improve your symptoms. Please call Black Hills Heart and Vascular to schedule an evaluation for possible additional treatment options.
Experienced Care for Deep Vein Thrombosis & May-Thurner Syndrome Symptoms in the Black Hills
If you are having symptoms concerning for DVT or May-Thurner Syndrome, please call Black Hills Heart and Vascular Institute at (605) 503-8192 to schedule an appointment.
