Copyright (c) 2026 Keren Vergara, Adel J. Tawil Y.
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Abstract
May-Thurner syndrome is a vascular condition characterized by compression of the left common iliac vein by the right common iliac artery, predisposing patients to deep vein thrombosis of the iliofemoral territory. Despite its clinical relevance, it remains an underdiagnosed May-Thurner syndrome is a vascular condition characterized by compression of the left common iliac vein by the right common iliac artery, predisposing patients to deep vein thrombosis of the iliofemoral territory. Despite its clinical relevance, it remains an underdiagnosed cause of venous thromboembolic disease, especially in young women or in patients with associated risk factors.
Cases presentation: We present two cases of female patients with left lower extremity deep vein thrombosis complicated by pulmonary embolism. The first case corresponds to a young patient without relevant medical history who was using oral contraceptives, in whom imaging studies confirmed extensive thrombosis and compression of the left common iliac vein, establishing the diagnosis of May-Thurner syndrome. The second case describes a patient with a previous history of deep vein thrombosis who presented recurrent thrombosis in the same territory associated with pulmonary embolism, in whom May-Thurner syndrome was considered a possible predisposing factor. Both patients were managed with an endovascular approach, with favorable clinical outcomes.
Conclusion: May-Thurner syndrome should be considered in patients with left lower extremity deep vein thrombosis, especially in extensive or recurrent presentations. The integration of imaging studies is essential for etiological diagnosis, and endovascular management represents an effective therapeutic strategy. Early recognition of this condition may reduce the risk of complications and improve clinical outcomes.
