A case report: recurrent DVTs related to May-Thurner Syndrome - A crush in the side!
Alice O'Mahony, University College Dublin
Study Aim
This poster presents a case of a 56-year-old female who presented to the emergency department with left
lower leg pain and swelling, with a history of left-sided deep vein thrombosis (DVT).
Methods
Ultrasound Doppler confirmed an extensive DVT from the left common femoral vein, femoral vein and
extending into the calf veins of the anterior tibial veins, the posterior tibial veins and the peroneal veins. A
subsequent computed tomography examination confirmed the DVT extended into the left common iliac vein.
Follow-up ultrasounds confirmed thrombus within the mid and distal left superficial femoral vein and popliteal
vein. The patient was followed up with a computed tomography lower-limb angiogram which confirmed the
presence of May-Thurner syndrome.
Results
Sonographic evaluation confirmed the presence of an extensive DVT within the left lower limb. These findings
together with subsequent computed tomography examinations confirmed May-Thurner Syndrome. The most
recent ultrasound (now negative for DVT) showed the presence of a venous stent in situ from the iliac vein to
the common femoral vein. Sonographic technique had to be modified as due to the presence of the venous
stent, compression could not be adequately achieved, however augmentation and colour Doppler confirmed
that there was no DVT and there was flow within the stent.
Students and Trainees
Conclusions
This case highlights the role of ultrasound alongside other imaging modalities such as computed tomography
in diagnosing rare venous conditions such as May-Thurner syndrome. The poster is an educational case also in
terms of sonographic technique, as due to the presence of a venous stent compression cannot be relied on to
exclude a DVT and augmentation and colour flow seen within the stent is used to exclude a DVT.