May-Thurner Syndrome (MTS), also known as iliac vein compression syndrome, affects blood flow in the legs. It happens when the right iliac artery in the pelvic area presses the left iliac vein against the spine, disrupting normal blood flow from the legs to the heart and increasing the risk of deep vein thrombosis (DVT).
Approximately 2% to 3% of the population is diagnosed with MTS, primarily affecting individuals assigned female at birth between the ages of 20 and 50. However, it is underdiagnosed, with evidence suggesting up to 22% of people may have the condition without showing symptoms. When symptoms do appear, they might include a dull ache, swelling, or heaviness in the affected leg.
Most people with MTS do not experience symptoms unless a blood clot forms in the affected leg, known as deep vein thrombosis (DVT). These symptoms often occur in the left leg due to vein compression.
The root cause of MTS isn’t exactly known, but experts believe that anatomical differences in the pelvic region’s arteries and veins might contribute. These variations could be present from birth or develop over time due to factors like pregnancy.
While anyone can get MTS, certain factors can increase your risk. This condition also elevates the chances of developing DVT in the affected leg. If you’re at risk, be mindful of symptoms and consider a medical assessment.
Diagnosing MTS involves examining symptoms and medical history, a physical check-up, and various tests. During the exam, healthcare providers look for signs like swelling or varicose veins and indicators of blood clots such as skin discoloration, pain, and warmth in the affected leg. If MTS is suspected, further tests will confirm the diagnosis.
MTS progresses through three stages, and understanding these stages helps healthcare providers decide on the best treatment strategies. The main goal of treating MTS is to enhance blood flow in the affected leg, alleviate symptoms, and prevent blood clots. Treatment varies based on whether there is a blood clot present.
If there are no blood clots, treatment usually involves angioplasty and stenting to open the narrowed vein. This involves inserting a balloon-tipped catheter to widen the vein, followed by placing a stent to keep it open and ensure healthy blood flow. If this doesn’t work, more invasive options like bypass surgery might be considered, though this is uncommon.
When MTS leads to deep vein thrombosis, treatment aims to break up existing clots and prevent new ones. If medications aren’t effective, placing a vena cava filter might be recommended to catch clots traveling from veins to the lungs. Compression socks can also help by encouraging blood flow and preventing clots.
In early-stage MTS, your healthcare provider might only recommend compression socks unless symptoms worsen or a clot forms. While there’s no certain way to prevent MTS, you can lower the risk of complications by maintaining vein health. This involves staying active, eating well, and avoiding smoking.
Research shows that with treatment, most people with MTS can enjoy a good quality of life and typical life expectancy. Following your treatment plan and making healthy lifestyle choices, like staying active and eating a balanced diet, can help prevent complications. Using compression stockings during extended travel or prolonged periods of standing or sitting and elevating your legs at day’s end can also improve blood flow and reduce swelling. Always consult your healthcare provider if you develop new symptoms, notice signs of a clot, or want to change your treatment strategy.
