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May-Thurner Syndrome


May-Thurner Syndrome (MTS) develops when veins in the pelvis are compressed along their anatomical paths form the legs to the main vein in the abdomen known as the inferior vena cava before it empties in the heart. As the veins are compressed, they become obstructed and the blood from the legs is not able to flow freely through the veins potentially causing a number of problems. The more serious consequence would be forming a blood clot (DVT) that may partially or completely block blood flow through the vein. Less serious but equally disabling and painful is congestion and increased pressure in the veins causing pain and varices in in the legs as well as pelvic varices.

At South Charlotte General and Vascular Surgery, our vascular surgeons have extensive experience in the diagnosis and treatment of these conditions and are often  able to treat the condition with a procedure done in our in-office accredited angiography suite. Book an appointment with us and get your questions answered!


Where are the veins compressed?

There are four areas where the iliac veins are commonly compressed by crossing arteries. Compression can occur at one or more sites causing swelling in one or both legs.


How do I know if I have MTS?

Most people who have chronic swelling in one or both legs do not know they have MTS, and the condition may exist for years without symptoms. Over time, repeated episodes of inflammation and scarring in the vein will lead to the development of symptoms as the pressure in the vein increases or the blood flow becomes so stagnant that a blood clot forms.

If you experience one or more of the following symptoms, you may have MTS and should discuss your symptoms with your health care provider or you may call us.

Symptoms of MTS may include:

  • Blood clot with severe leg swelling, particularly if it occurs in a patient with no known risk factors for DVT.
  • Chronic swelling one both or both leg unresponsive to initial conservative measures, which is often associated with pain, heaviness, aching, restlessness, throbbing, or varicose veins.
  • Pelvic, hip and back pain with leg pain
  • Venous leg ulcers in young patients

One may also suspect t MTS when:

  • Varicose veins develop in unusual areas like the upper inner thigh or private area and on or underneath the buttock, particularly if it occurs during pregnancy.
  • Vein problems occurring early in life—teenage or early twenties particularly in tall thin young women (e.g. a tall thin teenage girl with swollen left leg)


How is pelvic vein compression diagnosed?

  • Abdominal and Pelvic Ultrasound: may be a very useful test but requires special technique to be able to identify the various locations where the veins may be compressed. Our accredited technologists are well versed and specially trained to evaluate pelvic vein compression accurately and precisely.
  • CT scan or MRI of the pelvis: when done in experienced imaging centers with dye and special filming techniques, both tests can provide a very accurate diagnosis and help our vascular specialists to plan intervention if needed.
  • Venography: the most definitive test is a direct visualization of the point of compression with intravascular ultrasound which allows them to identify and calculate the degree of the compression (see: treatment of MTS).

The treatment of pelvic vein compression can now be safely done in our accredited angiographic suite in our office, right here in South Charlotte.  Different treatments may be recommended to relieve the compression and resolve your symptoms - depending on the cause and degree of the compression. (see: Stenting)

At South Charlotte General and Vascular Surgery, we are committed to provide you with the best care and best outcomes possible.

If you experience any of the above symptoms or think you may have a pelvic compression syndrome, please call one of our MTS specialists or make an appointment online.


South Charlotte General and Vascular Surgery
13430 Hoover Creek Blvd
Charlotte, NC 28273
Phone: 704-459-3028
Fax: 704-710-8045

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