scholarly journals The therapeutic approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a systematic review

10.3823/2431 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Modesto Leite Rolim Neto ◽  
Thaís Abreu Luedy ◽  
Isadora Rodrigues Da Costa ◽  
João Vitor Pimentel ◽  
Francisco Henrique Peixoto Da Silva
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Endovascular Treatment ◽  
Therapeutic Approach ◽  
Radiofrequency Energy ◽  
Peripheral Vascular ◽  
Venous Flow ◽  
Compression Syndrome

May-Thurner Syndrome is a clinical condition which causes a variety of vascular symptoms, resulting from pelvic and lower extremity venous flow obstruction caused by the compression of the iliac vein by overlying iliac artery. Treatment paradigms have changed as experience with endovascular modalities has evolved, making traditional surgical treatment strategies essentially obsolete and a endovascular treatment with angioplasty and stenting along selective thrombolysis has become the standard for symptomatic the syndrome. The objective of this present study is to show the therapeutic approach in treatment when there’s no presence of Deep Venous Thrombosis (DVT) symptoms. To accomplish this purpose, a systematic review of articles about May-Thurner Syndrome and its management therapies, published from January 1, 2005 to September 20, 2015, on PubMED and SCOPUS databases, was carried out. Search terms were “may-thurner syndrome” (medical subject headings [MeSH term]), “iliocaval compression syndrome” (MeSH), “cockett syndrome” (MeSH), “peripheral vascular diseases” (MeSH), and “treatment” (keyword). Of the 89 retrieved studies, 14 met the elegibility criteria. Retrieved studies covered that without correction of this syndrome, patients are at continued risk for recurrent deep vein thrombosis and post-thrombotic syndrome. Considering the therapy, systemic anticoagulation is the first component, and endovascular treatment appears to be superior to conventional surgical treatment. It should be the first line of therapy. Furthermore, there has been multiple advences in the recent years for chronic arterial occlusions using techniques such as blunt micro dissection, radiofrequency energy and laser. In the absence of deep venous trombosis, conservative treatments are preferred. To conclude, based on the review of the literature, a combination of conservative and endovascular therapy usually provides the best treatment in most cases. Thus, further researches must be done to advance in the matter of therapeutic of the non-DVT form of May-Thurner Syndrome.   Keywords: May-Thurner Syndrome, Iliocaval Compression Syndrome, Cockett Syndrome, Peripheral Vascular Disease, Treatment.

Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis: A single-center retrospective study

Vascular ◽  
2021 ◽  
pp. 170853812110037
Author(s):  
LK Tu ◽  
ML Nie ◽  
J Fu ◽  
FY Liu ◽  
YK Chen ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Endovascular Treatment ◽  
Varicose Veins ◽  
Iliac Vein ◽  
Lesion Group ◽  
Technical Success Rate ◽  
Compression Syndrome ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome

Background To compare the efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) with or without acute deep venous thrombosis of lower extremity. Methods This study retrospectively analyzed the clinical data of 300 IVCS patients, who received endovascular treatment between January 2013 and December 2017. According to whether IVCS was complicated by deep venous thrombosis or not, these patients were divided into non-thrombotic iliac vein lesion group (NIVL group, n = 127) and post-thrombotic iliac vein lesion group (PIVL group, n = 173). After endovascular treatment, all patients were followed up to assess the symptoms improvement and to evaluate the patency of iliac vein. Results The technical success rate was 98% (294/300), and percutaneous transluminal angioplasty with stenting was adopted in 294 cases. The incidence of perioperative complications was 36.33% (109/300), but no severe complications occurred. During a mean follow-up of 22.3 months (range 6–30 months), 9(6.82%, 9/132) patients in PIVL group had recurrence of deep venous thrombosis, but nobody had deep venous thrombosis and varicose veins recurrence in NIVL group. The effective rate of endovascular treatment in NIVL group and PIVL group was 96.88% and 90.15% ( P =  0.050), while the cumulative primary patency of iliac vein in NIVL group was significantly higher than that in PIVL group ( P =  0.008). Conclusions The endovascular treatment is an effective, feasible, safe method for treating IVCS. There is no difference in the efficacy of IVCS patients with or without deep venous thrombosis, but the medium and long-term patency of patients with deep venous thrombosis is lower than that in patients without deep venous thrombosis.

Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Jakob Martin Burgstaller ◽  
Johann Steurer ◽  
Ulrike Held ◽  
Beatrice Amann-Vesti
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Cochrane Library ◽  
Compression Stockings ◽  
Post Thrombotic Syndrome ◽  
Study Results ◽  
Preventive Efficacy ◽  
One Year ◽  
The Cochrane Library

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

A systematic review and meta-analysis on endovascular treatment as an attractive alternative for acute superior mesenteric venous thrombosis

Vascular ◽  
2021 ◽  
pp. 170853812199127
Author(s):  
Lixin Wang ◽  
Enci Wang ◽  
Fei Liu ◽  
Wei Zhang ◽  
Xiaolong Shu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Published Data ◽  
Mesenteric Venous Thrombosis ◽  
Surgery Group

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

scholarly journals A Systematic Review of Percutaneous Mechanical Thrombectomy in the Treatment of Deep Venous Thrombosis

2011 ◽  
Vol 41 (4) ◽  
pp. 554-565 ◽  
Author(s):  
A. Karthikesalingam ◽  
E.L. Young ◽  
R.J. Hinchliffe ◽  
I.M. Loftus ◽  
M.M. Thompson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Mechanical Thrombectomy ◽  
Percutaneous Mechanical Thrombectomy

PREVENTION OF CATHETER-ASSOCIATED DEEP-VENOUS THROMBOSIS: A SYSTEMATIC REVIEW.

2004 ◽  
Vol 52 ◽  
pp. S266
Author(s):  
A. C. Kirkpatrick ◽  
S. W. Rathbun ◽  
T. L. Whitsett ◽  
M. W. Bronze
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis
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