Síndrome de May-Thurner en una paciente con antecedentes de Artritis Reumatoidea

Claudia Alexandra  Alcocer Vargas; Camila  Martínez Arqueros

doi:10.54789/rs.v3i1.36

Authors

Claudia Alexandra Alcocer Vargas Sanatorio Juncal, Servicio de Clínica Médica, Temperley, Provincia de Buenos Aires, Argentina. https://orcid.org/0009-0004-1799-1899
Camila Martínez Arqueros Sanatorio Juncal, Servicio de Diagnóstico por Imágenes, Temperley, Provincia de Buenos Aires, Argentina. https://orcid.org/0009-0007-6595-5704

DOI:

https://doi.org/10.54789/rs.v3i1.36

Keywords:

May-Thurner syndrome, deep vein thrombosis, rheumatoid arthritis, computed tomography angiography, angioplasty, stents

Abstract

Introduction: May-Thurner Syndrome (MTS) is estimated to be present in between 2 and 5% of patients with a lower limb venous disorder. Early clinical suspicion is essential to confirm its diagnosis as its treatment differs from other causes of deep vein thrombosis (DVT). If diagnosis is missed, recurrence of thrombosis and eventual pulmonary thromboembolism can lead to significant morbidity and mortality. Treatment with oral anticoagulation alone is insufficient. Endovascular treatment includes thrombolysis, thrombus aspiration, and stent implantation.

Case presentation: A 41-year-old female patient with a history of rheumatoid arthritis presented with extensive lower limb DVT. MTS diagnosis was possible with clinical evaluation and angiography. Excellent results were obtained with endovascular treatment and oral anticoagulation.

Conclusion: Since MTS is frequently underdiagnosed, it is inadequately treated. Diagnosis is based on clinical suspicion and imaging methods with high sensitivity and specificity, such as computed tomography angiography. The patient was successfully treated with pharmacochemical thrombolysis, iliac vein angioplasty, and self-expanding stent implantation.

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