About stents for treating May-Thurner Syndrome
May-Thurner syndrome, also known as iliac vein compression syndrome, is a pelvic condition in which the right common iliac artery compresses the left iliac vein.
This may cause discomfort, swelling and-or blood clots. The condition increases the risk of deep vein thrombosis (DVT). DVT is a blood clot that may partially or completely block blood flow through the vein. With May-Thurner syndrome, the patient often presents with compression of the left common iliac vein by the overlying right common iliac artery. Since this leads to pooling (stasis of blood), the patient is predisposed to the formation of blood clots.
What is a stent?
A stent is often placed during the angioplasty procedure to keep the vein open. A stent is a small, metal mesh braided tube that acts as a scaffold or support to keep the artery open so blood can flow properly. When a stent is placed into the body, the procedure is called stenting. There are different kinds of stents. Most are made of a metal or plastic mesh-like material. The stent used for treating May-Thurner Syndrome is a small, metal mesh braided tube to hold open the vein. It is left in the body permanently.
Before a stent can be placed, any clots must be treated.
What are the treatment options for May-Thurner syndrome?
Treatment options used for May-Thurner Syndrome are aimed at resolving the symptoms and risks associated with DVT. Stenting of the iliac vein is often important in the treatment of May-Thurner Syndrome. If there is a clot, however, that is the first course of action using pharmaco-mechanical thrombolysis or catheter-directed thrombolytic therapy.
- Pharmacomechanical thrombolysis – Blood-thinning medications may help to prevent blood clots. There are several drugs available; when use of blood thinners is indicated, you will be carefully monitored to insure that you have the right dosage.
- Catheter-directed thrombolytic therapy – This nonsurgical treatment uses clot-dissolving medications, called throbolytics, to dissolve blood clots. The anti-thrombolytic, or clot-busting, medicine, is delivered via a catheter to break up and dissolve the blood clot.
What is the stenting procedure?
Once the blood clot is removed from the vein (usually by thrombolysis), the compressed vein is forced open with angioplasty and the structure is maintained with the use of a stent. Angioplasty – Patients with May–Thurner syndrome may require an angioplasty of the iliac vein.
- Angioplasty is a nonsurgical treatment option used to widen the affected vein after the blood clot has been dissolved. During angioplasty, a small balloon at the tip of the catheter is inflated to stretch the vein open and increase blood flow. Angioplasty is a nonsurgical treatment option performed by an intervention radiologist. The procedure is used to widen the vein after a blood clot has been dissolved. In this procedure, a small balloon at the tip of the inserted catheter is inflated. This stretches the vein and increases the blood flow.
- Stenting – A stent is often placed during the angioplasty procedure to keep the vein open. A stent is a small, metal mesh braided tube that acts as a scaffold.
What are pre- and post-treatment options?
- Thrombectomy – If the patient has extensive thrombosis, it may be appropriate to consider pharmacologic and-or mechanical thrombectomy (also known as pharmacomechanical thrombectomy) to decrease post-thrombotic syndrome.
- Vena Cava – While vena cava filters are not always used directly for May-Thurner Syndrome, the filter is often used to treat complications associated with the development of a DVT. The filter may be a treatment option for certain patients who cannot take blood-thinning (anticoagulant) medications. or for those where clots continue to develop despite the use of anticoagulants. The filter can prevent blood clots from moving from the vein in the legs to the lung— a pulmonary embolism. This treatment can help to reduce the risk of a pulmonary embolism. Vena cava filters may be a treatment option for select patients who cannot take anticoagulant (blood-thinning) medications and for patients who are taking anticoagulants and continue to develop clots. Vena cava filters are not always used for patients with May-Thurner syndrome but are often used to treat complications associated with the development of a DVT. The filter can prevent blood clots from moving from the vein in the legs to the lung (pulmonary embolism).
What outcomes can I expect from treatment?
And what are pre- and post-treatment options? Treatment outcomes for May-Thurner syndrome are generally very good. If identified soon after a deep vein clot has formed, the syndrome can usually be treated with full resolution of symptoms.