Mechanical Thrombectomy and Venous Stenting for Acute Deep Vein Thrombosis Caused by May–Thurner Syndrome at Dong Nai General Hospital: A case report

Abstract

Introduction: May–Thurner syndrome (MTS), caused by compression of the left common iliac vein by the overlying right common iliac artery, is an important anatomical factor leading to iliofemoral deep vein thrombosis (DVT). Current optimal management includes mechanical thrombectomy, venous angioplasty, and stent implantation to restore venous patency and correct the underlying obstruction.

Case report: An 81-year-old female presented with a three-day history of painful swelling of the left leg. Doppler ultrasound and CT venography revealed extensive iliofemoral thrombosis from the popliteal vein up to the iliac vein, with severe iliac venous stenosis consistent with MTS. Endovascular intervention was performed through bilateral popliteal access, including thrombectomy using an 8F Penumbra catheter, angioplasty with a 12-mm Atlas Gold balloon, and deployment of a 14-mm Venovo stent. Post-procedural venography demonstrated good venous flow with no residual thrombosis. After three days, leg swelling markedly improved, and limb circumference almost completely normalized.

Conclusion: Endovascular therapy combining thrombectomy, angioplasty, and venous stenting is effective and safe in treating MTS-related iliofemoral DVT. Successful implementation at Dong Nai General Hospital highlights the expanding capability of provincial hospitals in performing advanced venous interventions, improving access to high-quality care without requiring referral to central centers.