MANAGEMENT OF DEEP VENOUS THROMBOSIS IN MAY-THURNER SYNDROME CASE REPORT

This is a case of a 37-year-old previously healthy female who presented to the hospital with new-onset left leg pain, which was diagnosed and treated as an ankle sprain. Latter on presented with leg swelling and left flank pain; a doppler ultrasound revealed extensive deep venous thrombosis involving the left lower limb, from the common femoral vein to the posterior tibial veins and the greater and lesser saphenous veins. She was started on therapeutic enoxaparin with no response, then she was on heparin infusion, unfortunately without any clinical response. A CT scan of the abdomen was requested before inferior vena cava (IVC) filter insertion revealed compression of the left common iliac vein where it passes behind the left common iliac artery, suggesting May-Thurner syndrome. A decision was made for Catheter-directed Thrombolysis and IVC Filter insertion. The patient underwent mechanical thrombectomy and lysis of a vascular clot, with successful results. The final venogram showed clear patency and no residual clot, and an IVC filter was inserted. The patient is currently stable and has shown improvement in symptoms and mobility.

Key words: Deep venous thrombosis; Iliac vein compression syndrome; May-Thurner syndrome; Thrombolysis; Coagulation disorders.