Endovascular Overlapping Stenting for Chronic Left Common Iliac Vein Occlusion in May Turner Syndrome: A Case report

Abstract

A 30 year old female was referred to the interventional radiology service with a history of persisting left lower limb swelling with an associated ulcer in the distal medial aspect of the leg. She had been evaluated at an outside medical facility and treated several times with warfarin for recurring deep vein thrombosis [DVT]. A Doppler US examination did not show any current DVT in the affected lower limb. A CT venogram showed compression of the left common iliac vein at the point where the right common iliac artery crossed it anteriorly, highly suggestive of May Turner Syndrome [MTS]. No intraluminal thrombus was demonstrated in the segment of the left common iliac vein distal to the obstruction. A conventional DSA venography confirmed total chronic occlusion of the proximal left common iliac vein by the overlying right common iliac artery with multiple pelvic venous collaterals confirming the diagnosis of MTS. The patient subsequently underwent successful endovascular stenting of the left iliac vein with two overlapping self expandable stents. The limb swelling gradually subsided and the venous ulcer healed. There has been no recurrence of the DVT in the subsequent one year follow up.

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