• May-Thurner Syndrome Complicated by Acute Iliofemoral Vein Thrombosis: Helical CT Venography for Evaluation of Long-Term Stent Patency and Changes in the Iliac Vein

    AJR:195, September 2010

    May-Thurner Syndrome Complicated by Acute Iliofemoral Vein Thrombosis: Helical CT Venography for Evaluation of Long-Term Stent Patency and Changes in the Iliac Vein


    Ung Bae Jeon, Jin Wook Chung, Hwan Jun Jae, Hyo-Cheol Kim, Sang Joon Kim, Jongwon Ha, Jae Hyung Park


    OBJECTIVE. The purpose of this study was to use CT venography to evaluate long-term patency and changes in the iliac veins after stent placement for acute iliofemoral vein throm¬bosis due to May-Thurner syndrome.

    MATERIALS AND METHODS. From December 1999 to July 2007, 30 patients (22 women, eight men; age range, 30-78 years; mean, 56.7 years) with acute iliofemoral vein thrombosis due to May-Thurner syndrome diagnosed with CT venography were treated with catheter-directed thrombolysis and stent placement. The patients underwent follow-up CT venography at variable intervals according to clinician discretion. The primary objective was to determine the primary patency of the stented segment. The secondary objective was to in-vestigate the potential role of CT venography by analyzing the morphologic features and in-terval changes in stented iliac veins. Cumulative primary and secondary stent patency rates were calculated by Kaplan-Meier estimation.

    RESULTS. Four stent occlusions and one stent collapse were found at the first follow-up CT venographic examination within 1 year (mean duration, 129.3 days) after treatment. One stent occlusion and one stent collapse were managed successfully. The primary and second¬ary patency rates were 83.3% and 90% 1 and 5 years after treatment. The morphologic fea-tures of the common iliac vein did not affect stent patency or expanded stent diameter. During sequential CT venographic follow-up, no new in-stent stenosis or occlusion was found.

    CONCLUSION. Iliac stents placed for May-Thurner syndrome with acute thrombosis had excellent long-term patency. Restenosis or occlusion occurred early, and initial luminal patency was well maintained during long-term follow-up.