May-Thurner Syndrome Treatments

Endovascular Treatments for May-Thurner Syndrome

People with May-Thurner syndrome (MTS) are at a high risk for dangerous blood clots called DVTs. If you have MTS, you may be eligible for minimally invasive treatments to take pressure off of your iliac vein and remove blood clots before they cause damage.

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Treatment Options | What to Expect

May-Thurner Syndrome Treatments

Interventional Radiology Procedures for MTS

Angioplasty and Stenting

Angioplasty is a non-surgical procedure that uses image guidance to place a small tube (catheter) into the compressed iliac vein. Once there, the radiologist inflates a tiny balloon to open the vessel for better circulation. The balloon and catheter are then removed.

This procedure alone isn’t usually enough to prevent future pressure on the vein. So once the vein is opened, the doctor uses the catheter to put an iliac vein stent in place. The stent is a mesh tube made out of a special metal called Nitinol. It’s sturdy enough to keep the vein open, and can be left safely in the body long-term.

Catheter-Directed Thrombolysis

If you have a deep vein thrombosis (DVT) caused by May-Thurner syndrome, our fellowship-trained interventional radiologists can use minimally invasive techniques to fix the issue without the need for surgery.

As the name suggests, this treatment starts by threading a catheter through the circulatory system to wherever your clot is located. After reaching the DVT, the catheter is used to deposit thrombolytic agents to break down the clot. The physician may also perform an angioplasty and stent placement to prevent future clots.1

Before Your Procedure

The first step to treating May-Thurner syndrome is to see your primary care provider for full diagnostic evaluation and testing. Depending on the severity of your condition, they may opt for surveillance with the use of blood thinners and compression stockings rather than procedural treatments. However, if your MTS symptoms require intervention, they’ll recommend speaking with an interventional radiologist like the team at University Radiology Vascular and Interventional Center.

After your consultation, we’ll schedule you for the appropriate procedure. The day before the procedure, you’ll get instructions on when to arrive, when to stop eating and drinking, and which medications to pause.

You’ll be brought to a pre-procedure area, given a medical gown, and meet one more time with the care team to answer any final questions. Then, you’ll be given a mild sedative, which should make you feel relaxed and sleepy.

After Treatment

When your procedure is complete, you’ll stay for a short time under medical monitoring while you wake up. If needed, you may stay at the hospital for a day or two for observation. Recovery generally takes less than two weeks. Some post-procedure pain can occur, but it’s usually mild and can be treated with ibuprofen or acetaminophen.

Most patients are prescribed blood thinners after stent placement or thrombolysis to reduce the risk of future blood clots.3 We’ll schedule a follow-up appointment to make sure you’re doing well. You should also follow up regularly with your primary care provider to keep an eye on your condition.

References:

  1. Butros SR, Liu R, Oliveira GR, Ganguli S, Kalva S. Venous compression syndromes: clinical features, imaging findings and management. Br J Radiol. 2013;86(1030):20130284. doi:10.1259/bjr.20130284
  2. Zhang X, Shi X, Gao P, et al. Endovascular Management of May-Thurner Syndrome: A Case Report. Medicine (Baltimore). 2016;95(4):e2541. doi:10.1097/MD.0000000000002541
  3. Mangla A, Hamad H. May-Thurner Syndrome. [Updated 2024 Mar 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554377/