May-Thurner Syndrome Treated with Endovascular Wall Stent - Report of two cases -

May-Thurner 증후군의 혈관 내 스텐트를 이용한 치료 - 치험 2예 -

  • Yoon, You-Sang (Dept. of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine) ;
  • Won, Je-Hwan (Dept. of Diagnostic Radiology, Ajou University School of Medicine) ;
  • Choi, Ho (Dept. of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine) ;
  • Soh, Dong-Mun (Dept. of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine) ;
  • Lee, Cheol-Joo (Dept. of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine) ;
  • Kim, Hyung-Tae (Dept. of Thoracic and Cardiovascular Surgery, Ajou University, School of Medicine)
  • 윤유상 (아주대학교 의과대학 흉부외과학교실) ;
  • 원제환 (아주대학교 의과대학 진단방사선과학교실) ;
  • 최호 (아주대학교 의과대학 흉부외과학교실) ;
  • 소동문 (아주대학교 의과대학 흉부외과학교실) ;
  • 이철주 (아주대학교 의과대학 흉부외과학교실) ;
  • 김형태 (아주대학교 의과대학 흉부외과학교실)
  • Published : 2003.03.01

Abstract

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.

중심정맥혈전증은 흔히 관찰되는 질병이다. 그러나 그 원인 중 오른총장골정맥이 왼총장골동맥의 눌림과 협착에 의해 정맥 흐름이 방해받는 경우가 드물게 있으며, 이를 May-Thurner 증후군 또는 장골눌림증후군(Iliac compression syndrome)이라 한다. 이에 대한 치료는 중심정맥혈전증이 있을 경우에 카테터를 이용한 혈전 용해술과 혈전 용해 후 왼총장골정맥 내 스텐트(Stent) 삽입이 추천되고 있다. 저자들은 좌측 하지 부종으로 내원하여 시행한 정맥조영술상 May-Thurner syndrome으로 진단된 2예에서 혈전용해술 및 풍선확장술과 왼총장골정맥 내에 스텐트를 삽입하여 성공적으로 치료하였기에 관련 문헌과 함께 보고하는 바이다.

Keywords

References

  1. JIVR v.11 Endo-vascular management of acute extensive iliofemoral deep venous trombosis caused by May-Thurner syndrome Patel NH;Stookey KR;Ketcham DB;Cragg AH.
  2. Semin Intervent Radiol v.4 Thrombolytic therapy for deep venous thrombosis Sherry S. https://doi.org/10.1055/s-2008-1076021
  3. Eur J Vasc Surg v.4 Venous function assessed during a five year after acute iliofemoral venous thrombosis treated with anticoagulation Akensson H;Brudin L;Dahlestrom JD(et al.) https://doi.org/10.1016/S0950-821X(05)80037-4
  4. Intervent Radiol Venous thrombolytic therapy and use of endovascular etents Semba CP;Dake MD.
  5. Radiology v.191 Iliofemral deep venous thrombosis: aggressive therapy with catheter-directed thrombolysis Semba CP;Dake MD.
  6. Angiology v.8 The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins May R;Thurner J. https://doi.org/10.1177/000331975700800505
  7. Cardiovasc Intervent Radiology v.21 Treatment of pelvic venous spur (May-thurner snydrome) with Self-expanding Matallic endoprostheses Binkert CA;Schoch E;Stuckamnn G(et al.) https://doi.org/10.1007/s002709900205
  8. 대흉외지 v.34 심부정맥혈전의 혈전용해술 이재원