A 55-year-old female presents with left leg swelling, pain, and pitting oedema for 3 weeks following pelvic malignancy treatment. May-Thurner syndrome is suspected. Which of the following best describes the anatomical basis of this syndrome?

• A Left common iliac artery compresses left common iliac vein against the lumbar vertebra ✓
• B Right common iliac artery compresses right common iliac vein
• C Inferior vena cava thrombosis due to hypercoagulability
• D Femoral vein compression by inguinal lymph nodes

Explanation

May-Thurner syndrome (iliac vein compression syndrome) occurs when the right common iliac artery crosses and compresses the left common iliac vein against the L5 vertebral body, creating a chronic intraluminal spur (venous web). This leads to left-sided DVT or chronic venous insufficiency, disproportionately affecting young women. Treatment is catheter-directed thrombolysis for acute DVT, followed by venous stenting of the compressed segment. Recognition is important because standard anticoagulation alone has high recurrence rates if the underlying compression is not addressed.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.