May-Thurner Syndrome
50 yrs old with 2 days history of left leg swelling, Doppler Ultrasould showed acute deep venous thrombosis in the left ilio-femoral viens.
Initial venogram 6 hours follow up 18 hours follow up
Initial venogram shows no flow in the left ilio-femoral vein consistent with acute deep venous thrombosis (DVT).
Follow up venogram 6 hours following the start of thrombolysis show some slight improvement
with large residual clot burden.
Follow up venogram 18 hours following the start of thrombolysis showing significant improvement
with some residual clots.
28 hours Follow up Post-stenting of left common iliac vein
Follow up venogram 28 hours following the start of thrombolysis demonstrate complete
resolution of the venous clots and uncover significant compression of the left common
femoral vein which is also called May-Thurner syndrome or Cockett syndrome.
The left iliac vein normally passes under the right common iliac artery during its normal
course. In some individuals, this anatomy results in compression of the left iliac vein
and can lead to band or web formation, subsequent stasis, and left leg DVT.
The reasons are poorly understood. This was successfully treated with stenting and
angioplasty, resulting in rapid resolution of the leg swelling.
Renal artery stenosis
56 yrs old female with poorly controlled hypertension and worsening renal function.
Selective right renal angiogram demostrate significant stenosis(narrowing) at the origin of the right renal artery( red arrow)
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