II. Epidemiology

  1. More common in women (RR 2)

III. Pathophysiology

  1. Compressed right iliac common artery (RICA) results in increased risk of ileofemoral DVT
  2. Arterial variants of RICA predispose to compression
  3. Resulting RICA pressure against lumbar bony Vertebrae results in bony spur formation
  4. RICA and Vertebral spurs compress iliac veins, resulting in Leg Edema and Deep Vein Thrombosis
    1. Left Deep Vein Thrombosis is more common

IV. Complications

  1. Deep Vein Thrombosis
    1. Responsible for 2 to 5% of DVTs (esp. females in their teens and twenties)
    2. Associated with proximal DVT (ileofemoral DVT)
  2. Phlegmasia

V. Imaging

  1. Magnetic Resonance Venography (MRV)
    1. Diagnostic for May-Thurner Syndrome

VI. References

  1. Jean-Louis and Sethuraman (2023) Crit Dec Emerg Med 37(7): 4-11

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