Surgery · Vascular Surgery (Arterial, Venous, Lymphatic Disorders)

A 40-year-old woman has recurrent left leg deep vein thrombosis and ultrasound reveals a non-compressible left common iliac vein with a filling defect extending to the external iliac vein. MR venography shows extrinsic compression of the left common iliac vein by the right common iliac artery. This condition is known as:

  • A Klippel-Trénaunay syndrome
  • B Paget-Schroetter syndrome
  • C Leriche syndrome
  • D May-Thurner syndrome (Cockett syndrome)
Correct answer: D. May-Thurner syndrome (Cockett syndrome)

Explanation

May-Thurner syndrome (Cockett syndrome) is caused by chronic compression of the left common iliac vein between the overlying right common iliac artery and the lumbar vertebra, leading to venous spur formation (intraluminal fibrotic webs), left-sided DVT, and post-thrombotic syndrome. It predominantly affects young women and is an important cause of unprovoked left iliac/femoral DVT. Treatment involves catheter-directed thrombolysis followed by venoplasty and stenting of the iliac vein. Paget-Schroetter involves axillary/subclavian venous thrombosis (effort thrombosis). Leriche syndrome is aorto-iliac occlusive disease causing claudication and impotence.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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