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Leg pain and swelling can be caused by a number of problems, many of them venous in nature. One serious condition with these symptoms is May-Thurner syndrome.

Caused by the compression of an important vein against the spine, May-Thurner syndrome is the narrowing of the vein that runs from the left leg to the vena cava. It typically presents with a left lower extremity that I slightly larger than the right.

The right iliac artery runs to the right leg. This artery can compress the left iliac vein against the spine, causing narrowing and scarring. In healthy patients, the right iliac artery simply runs over the left iliac vein, without applying pressure.

Patients with May-Thurner syndrome will experience left leg swelling and pain, and in more severe cases may experience blood clots or deep vein thrombosis in the left leg.

How Do I Know If It’s May-Thurner Syndrome?

As before mentioned, left leg swelling and pain can be symptoms of various venous issues, like venous reflux or varicose veins. Various tests can detect May-Thurner syndrome, such as ultrasound imaging, MRI, CT scans, venogram or phlebogram.

Treatment Options

The narrowed vein in patients with May-Thurner syndrome can be treated in various ways. Stenting can hold the vein open. Bypass surgery, another option, rerouts blood flow around the narrowed, scarred portion of the left iliac vein.

In some cases, the best option is to surgically reposition the right iliac artery, the artery that causes the pressure. Surgery can move the artery behind the left iliac vein.

In other cases, what a patient needs is removal of blood clots in the vein, in the pelvic region. Using medication and a specialized device, physicians can remove these clots.

How Common is It?

May-Thurner syndrome is relatively rare, though it often goes unrecognized, research shows. It is much more common in women than men.


“May-Thurner syndrome offers several potential treatment options for patients. One option is venous angioplasty and stenting, a minimally invasive procedure involving the insertion of a catheter with a balloon on its tip into the affected vein. The balloon is then inflated to fully open the vein, and a small mesh tube called a stent is placed to maintain proper blood flow. This procedure helps alleviate symptoms and promote better circulation.

Another treatment option is bypass surgery, which may be recommended in certain cases. This surgical procedure involves redirecting blood flow around the narrowed or scarred section of the left iliac vein. By creating a bypass graft, the compressed portion of the vein is bypassed, restoring normal blood flow and alleviating symptoms.

Surgical repositioning of the right iliac artery is also a consideration for some patients. This procedure involves moving the artery behind the left iliac vein to relieve pressure and prevent complications such as deep vein thrombosis (DVT). By removing the source of compression, this technique helps alleviate symptoms and improve overall vascular health.

In some instances, treatment may involve the removal of blood clots in the pelvic region. By utilizing specialized devices and medications, physicians can safely eliminate these clots, reducing the risk of complications and improving blood flow.

In cases where deep vein thrombosis develops as a result of May-Thurner syndrome, doctors may prescribe blood thinners, clot-busting medications, or other appropriate treatments to address the condition and prevent further complications.

These various treatment options provide hope for individuals with May-Thurner syndrome, as they aim to alleviate symptoms, restore proper blood flow, and improve overall vascular health. Consulting with a healthcare professional can help determine the most suitable treatment plan based on individual needs and circumstances.