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Percutaneous treatment of deep vein thrombosis in May-Thurner syndrome

Authors
 Jong-Youn Kim  ;  Donghoon Choi  ;  Young Guk Ko  ;  Sungha Park  ;  Yangsoo Jang  ;  Do Yun Lee 
Citation
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.29(4) : 571-575, 2006 
Journal Title
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 0174-1551 
Issue Date
2006
MeSH
Adult ; Female ; Functional Laterality ; Humans ; Iliac Artery* ; Iliac Vein* ; Male ; Middle Aged ; Phlebography ; Pulmonary Embolism/complications ; Retrospective Studies ; Thrombolytic Therapy ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/therapy*
Keywords
Deep vein thrombosis ; May-Thurner syndrome ; Stent ; Thrombolysis
Abstract
BACKGROUND/PURPOSE: May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery with subsequent development of deep vein thrombosis and chronic venous insufficiency. We report our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome using endovascular techniques. METHODS: The study group comprised 21 patients (8 men, 13 women; mean age 51 years) diagnosed with May-Thurner syndrome by venogram. Eighteen patients were treated with catheter-guided thrombolysis; 3 patients with short segment involvement did not require thrombolysis. After completion of the thrombolytic therapy, the residual venous narrowing was treated by balloon angioplasty and/or placement of a self-expandable stent. RESULTS: The mean total dose of urokinase was 4.28 +/- 1.89 million units, and the mean duration of infusion was 72 +/- 35 hr. Eighteen of the 21 patients received stent deployment. The mean diameter of the stents was 12.9 +/- 2.0 mm. Initial technical successes with immediate symptom resolution were achieved in 20 of the 21 patients (95%). We performed a follow-up venogram 6 months after procedure and checked clinical symptoms at outpatient clinics (mean follow-up duration 10.8 months). Among the patients who received stent implantation, 2 had recurrent thrombotic occlusion during the follow-up period. Three patients, who did not receive stent implantation, all had recurrent thrombosis. There were no major bleeding complications except in 1 patient who developed retroperitoneal hematoma. CONCLUSION: Catheter-guided thrombolysis and angioplasty with stent implantation is a safe and effective method for the treatment of May-Thurner syndrome.
Full Text
http://link.springer.com/article/10.1007%2Fs00270-004-0165-7
DOI
10.1007/s00270-004-0165-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Lee, Do Yun(이도연)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111033
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