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.