Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Surgical Venous Thrombectomy for Chronic May-Thurner Sysndrome - 2 cases report -

만성 메이-터너 증후군에서 시행한 외과적 혈전 제거술 - 2예 보고 -

  • Yie, Kil-Soo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kangwon National University) ;
  • Kim, Yong-Hoon (Department of Internal Medicine, College of Medicine, Kangwon National University) ;
  • Min, Sun-Kyung (Department of Thoracic and Cardiovascular Surgery, Seoul Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Hyoung-Rae (Department of Interventional Radiology, College of Medicine, Kangwon National University) ;
  • Lee, Bong-Ki (Department of Internal Medicine, College of Medicine, Kangwon National University) ;
  • Kang, Seong-Sik (Department of Anesthesiology and Pain Clinic, College of Medicine, Kangwon National University)
  • 이길수 (강원대학교 의과대학 흉부외과학교실) ;
  • 김용훈 (강원대학교 의과대학 내과학교실) ;
  • 민선경 (인제대학교 의과대학 서울백병원 흉부외과) ;
  • 김형래 (강원대학교 의과대학 영상의학교실) ;
  • 이봉기 (강원대학교 의과대학 내과학교실) ;
  • 강성식 (강원대학교 의과대학 마취통증의학교실)
  • Published : 2009.10.05
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Abstract

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

메이-터너 증후군은 좌측 장골정맥이 우측 총장골동맥에 눌러져 발생하는 장골-대퇴정맥의 심부정맥 혈전증이다. 비록 카테터를 이용한 혈전제거 술과 혈전용해 및 스텐트 삽입술이, 기술적 수월함과 낮은 재발율로 인해 급성기 혹은 아급성기의 메이-터너 증후군 환자들에게 보편적인 치료법으로 인식되고 있지만 일부 환자에서는 치명적인 합병증을 일으킬 수 있다. 더군다나 만성 메이-터너 증후군 환자에서의 궁극적인 적절한 치료법은 아직 정립되어 있지 않다. 저자들은 2예의 만성 메이-터너 증후군 환자에서 혈관 내 치료법 실패 후 수술적 혈전제거 술과 스텐트 삽관술, 동정맥루 조성술을 적용하였다. 이러한 수술적 치료법은 일부 혈관 내 치료가 적응증이 될 수 없는 환자에게 유의한 치료법으로 이용될 수 있을 것이다.

Keywords

References

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