Ultrasound diagnosis for endovascular treatment of May–Turner syndrome
https://doi.org/10.24835/1607-0763-2020-1-113-118
Abstract
The experience of using ultrasound diagnostics for endovascular treatment of May-Turner syndrome is given.
The purpose of the study was to evaluate the diagnostic capabilities of ultrasound examination of stents of the iliac veins in patients with varicose pelvic disease in the presence of May–Turner syndrome.
Material and methods. 13 patients with May–Turner syndrome and associated pelvic varicose veins were studied. The following methods were used for instrumental diagnostics: ultrasound examination of the pelvic veins, multispiral computerized phlebography, radiopaque phlebography.
Results. 10 women had pelvic enlargement. Dilation of the veins of the plexus plexus from 5 to 11 mm, uterine veins from 4 to 8 mm, and ovarian veins from 5 to 7 mm was noted. After stenting, the pelvic veins were reduced. In 9 patients, stents functioned throughout the observation period. In 1 patient, stent thrombosis was diagnosed the next day, in 1 – after 10 days. After selective catheter-driven thrombolysis and restenting, stents are passable. In 2 patients, partial stent thrombosis was diagnosed after 1 month, patients continue to be observed with parietal thrombomasses in stents.
Discussion. The diagnosis of May–Turner syndrome and varicose veins of the pelvis was made in the hospital at the diagnostic stages of the study. Already 3 months after stenting, we observed a decrease in the diameter of all the pelvic veins. Endovascular stenting is the modern and most effective method for restoring iliac vein patency for patients with SMT. During ultrasound, we completely located the stents in various planes and gave a full description of their functioning, occlusion and parietal thrombosis.
Conclusion. ultrasound is a non-invasive and highly effective method for the diagnosis of varicose pelvic disease in patients before and after endovascular treatment of May-Turner syndrome.
About the Authors
E. E. FominaRussian Federation
Cand. of Sci. (Med.), Head of the Department of Ultrasound of Research №1
Phone: +7-917-273-52-59 420064 Republic of Tatarstan, Kazan’, Orenburg Tract str., 138
M. G. Tukhbatullin
Russian Federation
Doct. of Sci. (Med.), Professor, Head of the Department of Ultrasound Diagnosis; Chief Specialist in Clinical Diagnostics
11, Mushtari str., 420012 Kazan’, Russian Federation
420064 Republic of Tatarstan, Kazan, Orenburg Tract Street, 138, Russian Federation
References
1. Ahmed O., Ng J., Patel M., Ward T.J., Wang D.S., Shah R., Hofmann L.V. Endovascular Stent Placement for May–Thurner Syndrome in the Absence of Acute Deep Vein Thrombosis. J. Vasc. Interv. Radiol. 2016; 27: 167–173.
2. May R., Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957; 8: 419–427.
3. Knipp B.S., Ferguson E., Williams D.M., Dasika N.J., Cwikiel W., Henke P.K., Wakefield T.W. Factors associated with outcome after interventional treatment of symptomatic iliac vein compression syndrome. J. Vasc. Surg. 2007; 46: 743–749.
4. Mousa A.Y., AbuRahma A.F. May–Thurner syndrome: update and review. Ann. Vasc. Surg. 2013; 27: 984–995.
5. De Graaf R., Arnoldussen C., Wittens C.H.A. Stenting for chronic venous obstructions a new era. Phlebology. 2013; 28 (Suppl. 1): 117–122.
6. Kuznetsov K.A., Kharkova M.V., Karpenko A.A., Laktionov P.P. Vascular stents: Approaches used to increase their clinical efficacy. Angiology and Vascular Surgery. 2018; 24 (2): 69–79. (In Russian)
7. Pokrovsky A.V., Ignatyev I.M., Gradusov E.G. Results of endovascular treatmentof obstructive lesions of veins of the iliofemoral segment. Angiology and Vascular Surgery. 2018; 24 (2): 57–62. (In Russian)
8. Heungman J. Endovenous Intervention of May–Thurner Syndrome with Thrombus beyond Iliac Vein Stenosis. Vasc. Specialist. Int. 2019; 35 (2): 90–94. https://doi.org/10.5758/vsi.2019.35.2.90
9. George R., Verma H., Ram B., Tripathi R. The effect of deep venous stenting on heal-ing of lower limb venous ulcers. Eur. J. Vasc. Endovasc. Surg. 2014; 48: 331–336.
10. Ascher E., Marks N., Hingorani A., Blumberg S., Rizvi A. The Bulls-Eye sign and other iliocaval-femoral venographic findings: a new classification to limit the use of intravascular ultrasound. VEITH symposium On-Demand 2016 Catalog. [Internet]. Availa-ble from: https//www.veithondemand.com/2016/php.
11. Hsieh M.C., Chang P.Y., Hsu W.H. et al. Role of threedimensional rotational venography in evaluation of the left iliac vein in patients with chronic lower limb edema. Int. J. Cardiovasc. Imaging. 2011; 27: 923–929.
12. Xu F., Tian Z., Huangc X., Xianga Y., Yao L., Zoua C., Fu C., Wang Y. A case report of May-Thurner syndrome induced by anterior lumbar disc herniation. Medicine. 2019; 98: 44 (e17706). https:// doi.org/10.1097/MD.0000000000017706
13. Wenda W., Yu Z., Yue-xin C. Stentingfor chronic obstructive venous disease: A current comprehensive meta-analisis and systematic review. Phlebology. 2016; 31 (6): 376–389.
Review
For citations:
Fomina E.E., Tukhbatullin M.G. Ultrasound diagnosis for endovascular treatment of May–Turner syndrome. Medical Visualization. 2020;24(1):113-118. (In Russ.) https://doi.org/10.24835/1607-0763-2020-1-113-118