Vascular crisscrossing

May-Thurner syndrome as the cause of a venous thromboembolism

Abstract

May-Thurner syndrome (MTS), also known as Cockett’s syndrome, is an anatomical-pathological condition that leads to obstructed venous flow due to external compression on the ilio-caval venous area by the right common iliac artery (RCIA) and the lower lumbar spine (usually the 5th lumbar vertebra). It can be asymptomatic and undetected throughout life or cause vascular morbidity, including deep vein thrombosis (DVT), especially reported in women of reproductive age. We report the case of an older woman diagnosed with an unprovoked DVT, a pulmonary thromboembolism (PTE) found on complementary tests and thromboses of the iliac and left ilio-femoral veins, with suspected MTS on thoracoabdominal angiography tomography. This was confirmed through an endovascular study and treated endovascularly and medically. This report highlights an underdiagnosed cause of VTE in an unusual age group.