Prevalence of May-Thurner Syndrome in Patients with Deep Vein Thrombosis at a Large Medical Referral Center.

Abstract

OBJECTIVE\n\u2002We set out to investigate the prevalence of May-Thurner syndrome (MTS) in a cohort of patients diagnosed with iliofemoral deep vein thrombosis at a large medical referral center.\n\n\nMATERIALS AND METHODS\n\u2002We retrospectively analyzed a cohort of 496 patients who were referred to the emergency unit of a large medical referral center with suspected venous thromboembolism (VTE) and were diagnosed with deep vein thrombosis of the iliac veins and/or the thigh on ultrasound. We retrospectively assessed the presence of MTS in the primary ultrasound examination and on additional imaging (available in n\u200a=\u200a193 patients).\n\n\nRESULTS\n\u2002Across all 496 patients with iliofemoral deep vein thrombosis, the median age was 70 years. 238 patients (48\u200a%) were female. The thrombosis was left-sided in 263\xa0cases (53\u200a%), right-sided in 208 cases (42\u200a%) and bilateral in 24 cases (5\u200a%). In the subgroup of patients with left-sided and bilateral thrombosis, the growth pattern was classified as ascending in 142 patients (50\u200a%), descending in 104 patients (36\u200a%) and unclear in 41 patients (14\u200a%). Additional imaging tests were available in 193 patients: 119 patients (41\u200a%) underwent CT, 18 patients (6\u200a%) MRI and 30 patients (10\u200a%) underwent phlebography. Within the subgroup of patients with left-sided and bilateral thrombosis, MTS was confirmed in 88 patients (31\u200a%), and the imaging findings in 17 patients (6\u200a%) were highly suspicious of MTS.\u200aDifferentiation was not possible in 86 patients (30\u200a%) and MTS was excluded in 96 patients (33\u200a%).\n\n\nCONCLUSION\n\u2002Underlying MTS is not uncommon in the selected cohort of patients with deep iliofemoral vein thrombosis at a large referral center and should be excluded by imaging.\n\n\nKEY POINTS\n\u2002 · May-Thurner syndrome (MTS) is a relatively frequent cause of deep vein thrombosis.. · MTS should be excluded in patients with left-sided or bilateral iliofemoral thrombosis.. · Cross-sectional imaging is helpful in this setting.. · Approximately one third of patients in this subgroup show signs of MTS..\n\n\nCITATION FORMAT\n· Heller T, Teichert C, Hafer J et\u200aal. Prevalence of May-Thurner Syndrome in Patients with Deep Vein Thrombosis at a Large Medical Referral Center. Fortschr Röntgenstr 2019; DOI: 10.1055/a-0959-6230.