The Importance of Diagnosis and Treatment of May-Thurner and Pelvic Congestion Syndromes Before Complications, in Patients with Thrombophilia
Journal of Surgery
Volume 6, Issue 4, August 2018, Pages: 88-91
Received: May 1, 2018; Accepted: May 28, 2018; Published: Jun. 14, 2018
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Authors
Diego Victor Nascimento, Department of Medicine, Universetary Center of João Pessoa (UNIPÊ), João Pessoa - PB, Brazil
Gabrielle Maria de Oliveira Kraychete da Silveira, Department of Medicine, Universetary Center of João Pessoa (UNIPÊ), João Pessoa - PB, Brazil
Helena Chaves de Queiroga, Department of Medicine, Universetary Center of João Pessoa (UNIPÊ), João Pessoa - PB, Brazil
Lidie Anne Diniz Viégas, Department of Medicine, Universetary Center of João Pessoa (UNIPÊ), João Pessoa - PB, Brazil
Sérgio Ricardo Ferreira Vieira, Department of Medicine, Faculty of Medical Sciences of Paraíba (FCM), João Pessoa - PB, Brazil
Francisco Chavier Vieira Bandeira, Department of Medicine, Federal University of Paraíba (UFPB), João Pessoa - PB, Brazil
Paulo Roberto da Silva Lima, Department of Medicine, Universetary Center of João Pessoa (UNIPÊ), João Pessoa - PB, Brazil
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Abstract
May-Thurner syndrome (MTS), initially observed in 1851 by Virchow as an anatomical variation of the left common iliac vein. In 1965, Cockett and Thomas supplemented the work of May and Thurner correlating with the observed symptoms. The syndrome is characterized by an anatomical anomaly that results in compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) [3]. It is also known as Cockett Syndrome, iliac vein compression syndrome and iliocaval compression syndrome [3]. Because of the stress arising from the pulsation of the artery, the intima layer of the vein undergoes a hypertrophy with consequent development of Deep Vein Thrombosis (DVT) [1, 3]. Because it prevents drainage to the inferior vena cava, MTS is related to the appearance of pelvic varices characterized by dilatation and reflux, venous stasis of the pelvic organs, having as main manifestation chronic pelvic pain (CPP) without inflammatory signs, although the CPP does not is a well-defined diagnostic criterion [5, 6]. In substitution for open surgery, appeared more effective methods such as endovascular surgery [7]. The patient in this case authorized the authors to describe her clinical case. We performed a search on the PubMed and Bireme databases. A white woman was complaining of pain in her lower extremities (LE), apart from feeling of heaviness and tiredness in her Right Lower Extremity (RLE), ankle edema, legs and pelvic varices. At physical examination, the patient had the presence (according to the CEAP classification) of C1, 3 varicose veins in the RLE and C1, 2, 3 varicose veins in the Left Lower Extremity (LLE). She was submitted to varied clinical treatment, and the investigation of the causes of the symptoms, including thrombophilia. She was not responding well to the treatment and the endovascular treatment of Cockett's syndrome was performed. Due to the non-release of the embolization of the ovarian veins by the patient's health plan there was a delaying for the right treatment of the patient, because she has ovarian varicose veins. The endovascular treatment of the May-Thurner and Pelvic Congestion Syndrome is safe and has excellent primary patency in the medium to long term.
Keywords
May-Thurner Syndrome, Venous Insufficiency, Pelvic, Cockett Symdrome, Therapeutic, Trombophilia
To cite this article
Diego Victor Nascimento, Gabrielle Maria de Oliveira Kraychete da Silveira, Helena Chaves de Queiroga, Lidie Anne Diniz Viégas, Sérgio Ricardo Ferreira Vieira, Francisco Chavier Vieira Bandeira, Paulo Roberto da Silva Lima, The Importance of Diagnosis and Treatment of May-Thurner and Pelvic Congestion Syndromes Before Complications, in Patients with Thrombophilia, Journal of Surgery. Vol. 6, No. 4, 2018, pp. 88-91. doi: 10.11648/j.js.20180604.12
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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