Deep Vein Th rombosis Associated with May-Th urner Syndrome in an Amyotrophic Lateral Sclerosis Patient -A Case Report-

Annals of Rehabilitation Medicine, 2011 · DOI: 10.5535/arm.2011.35.3.441 · Published: September 1, 2011

Cardiovascular Science Neurology Rehabilitation

Simple Explanation

May-Thurner syndrome (MTS) occurs when the left iliac vein is compressed by the right iliac artery. This compression can lead to deep vein thrombosis (DVT) due to blood stasis. DVT is common in patients with spinal cord injuries, old age, immobilization, quadriplegia, obesity, or those taking oral contraceptives. This case report presents an ALS patient with gait disturbance who developed DVT due to venous blood stasis. Early diagnosis of DVT with MTS is difficult, and recurrence is common with inappropriate treatment. Accurate diagnosis and appropriate treatment, like angioplasty or stent insertion, are crucial.

Study Duration

Not specified

Participants

One 71-year-old woman with ALS

Evidence Level

Case Report

Key Findings

1
A 71-year-old woman with ALS presented with pain and edema in her left leg and was diagnosed with DVT in the left common iliac and femoral veins.
2
Venography showed a complete obstruction in the left collateral, iliac, femoral, and popliteal veins, and MTS was suspected due to compression of the left iliac vein by the right iliac artery.
3
Treatment with thrombectomy, stent insertion, balloon angioplasty, and Inferior Vena Cava filter resulted in improved blood flow, reduced swelling and pain, and functional recovery of the leg.

Research Summary

This case report describes a 71-year-old female ALS patient who developed DVT associated with May-Thurner syndrome (MTS). MTS is the compression of the left common iliac vein by the right common iliac artery. The patient presented with pain and edema in the left leg. Diagnostic imaging revealed DVT and compression of the left iliac vein. She was successfully treated with thrombectomy, stent insertion, and balloon angioplasty. The authors emphasize the importance of considering MTS in ALS patients presenting with DVT, particularly in the left leg, to prevent relapses and ensure successful treatment.

Practical Implications

Increased Awareness

Clinicians should be aware of the possibility of MTS in ALS patients presenting with DVT, especially in the left leg.

Diagnostic Venography

Venography should be considered in ALS patients with DVT to rule out MTS and guide appropriate treatment.

Aggressive Intervention

Aggressive interventions such as angioplasty and stenting should be considered in ALS patients with DVT and MTS to maintain long-term blood flow and prevent relapse.

Study Limitations

1
Single case report limits generalizability
2
Lack of long-term follow-up data
3
Limited information on the patient's specific ALS disease progression and other comorbidities

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