Introduction
May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is an
anatomically variable condition in which the right common iliac artery overlies and subsequently compresses the left common iliac vein against the lower lumbar spine, commonly the fifth lumbar vertebra1. This results in luminal narrowing and intimal hyperplasia, which predispose to venous stasis and recurrent deep vein thromboembolisms (DVT). Definitive treatment in most cases is endovascular intervention followed by maintenance anticoagulation, which becomes all the more necessary because of the pro thrombotic effect of the intravascular device. Here we present a case of recurrent DVTs in a patient who was diagnosed with MTS despite undergoing definitive treatment (i.e., endovascular intervention followed by systemic anticoagulation). This case report emphasizes the need for proper guidelines on acute and long-term management of May-Thurner syndrome, especially post-stent thrombotic treatment in patients with other thrombophilic conditions.