The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome

May–Thurner syndrome (MTS) is characterized by the formation of an intravenous scar or venous “spur” resulting from chronic pulsatile compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the fourth or fifth lumbar vertebral body. This pulsatile compression...

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Main Authors: Tanner M. Dunn, Clint A. Hayes
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Vascular Medicine
Online Access:http://dx.doi.org/10.1155/crvm/1579198
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author Tanner M. Dunn
Clint A. Hayes
author_facet Tanner M. Dunn
Clint A. Hayes
author_sort Tanner M. Dunn
collection DOAJ
description May–Thurner syndrome (MTS) is characterized by the formation of an intravenous scar or venous “spur” resulting from chronic pulsatile compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the fourth or fifth lumbar vertebral body. This pulsatile compression creates a flow-limiting stenosis of the LCIV, leading to increased intravenous pressure in the veins draining the left lower extremity (LLE). Consequently, this elevated venous pressure manifests as a spectrum of chronic symptoms including unilateral LLE edema, pain, tenderness, warmth, skin inflammation, and discoloration, along with pelvic symptoms such as sensation of fullness and dyspareunia. Furthermore, MTS significantly elevates the risk of venous thromboembolism characterized by LCIV deep vein thrombosis (DVT) and potentially fatal pulmonary embolism (PE). Treatment options for MTS range from anticoagulant therapy to, in severe cases, operative intervention. Herein, we present a case of a 79-year-old male with MTS who experienced a near-fatal DVT that led to PE, compounded by a chronically distended urinary bladder, necessitating immediate operative removal of the PE.
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spelling doaj-art-621b6be87ced4fdcbc6155afebf531fc2025-08-20T03:06:20ZengWileyCase Reports in Vascular Medicine2090-69942025-01-01202510.1155/crvm/1579198The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner SyndromeTanner M. Dunn0Clint A. Hayes1Texas College of Osteopathic MedicineVascular SurgeryMay–Thurner syndrome (MTS) is characterized by the formation of an intravenous scar or venous “spur” resulting from chronic pulsatile compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the fourth or fifth lumbar vertebral body. This pulsatile compression creates a flow-limiting stenosis of the LCIV, leading to increased intravenous pressure in the veins draining the left lower extremity (LLE). Consequently, this elevated venous pressure manifests as a spectrum of chronic symptoms including unilateral LLE edema, pain, tenderness, warmth, skin inflammation, and discoloration, along with pelvic symptoms such as sensation of fullness and dyspareunia. Furthermore, MTS significantly elevates the risk of venous thromboembolism characterized by LCIV deep vein thrombosis (DVT) and potentially fatal pulmonary embolism (PE). Treatment options for MTS range from anticoagulant therapy to, in severe cases, operative intervention. Herein, we present a case of a 79-year-old male with MTS who experienced a near-fatal DVT that led to PE, compounded by a chronically distended urinary bladder, necessitating immediate operative removal of the PE.http://dx.doi.org/10.1155/crvm/1579198
spellingShingle Tanner M. Dunn
Clint A. Hayes
The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
Case Reports in Vascular Medicine
title The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
title_full The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
title_fullStr The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
title_full_unstemmed The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
title_short The Hidden Threat: Chronic Urinary Retention and Thromboembolism in Underlying May–Thurner Syndrome
title_sort hidden threat chronic urinary retention and thromboembolism in underlying may thurner syndrome
url http://dx.doi.org/10.1155/crvm/1579198
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