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KEY FACTS
Terminology
Preprocedure
Post Procedure
Outcomes
TERMINOLOGY
Synonyms
- May-Thurner syndrome = Cockett syndrome, iliac vein or iliocaval compression syndrome
- Femoral vein = superficial femoral vein
Definitions
- Venous thromboembolism (VTE)
- Includes deep vein thrombosis (DVT) & pulmonary embolism (PE)
- Significant source of morbidity & mortality
- Occurs in 1:1,000 people yearly
- Catheter-directed thrombolysis (CDT)
- Delivery of fibrinolytic agent directly into thrombus via intravascular catheter
- Allows ↑ dose of fibrinolytic into thrombus
- ↓ fibrinolytic bypassing thrombus via collaterals
- May ↓ total fibrinolytic dose, treatment/hospitalization time
- Mechanical thrombectomy (MT)
- Removal of thrombus without lytics; removes risk of lytic-related hemorrhage
- Often involves aspiration devices
- Pharmacomechanical thrombolysis (PMT)
- Thrombolytic infusion + mechanical thrombus disruption
- ↑ contact area between fibrinolytic & thrombus
- May improve thrombolytic action, further decreasing fibrinolytic dose & treatment/hospitalization time
- Chronic venous insufficiency (CVI)
- Venous reflux & ambulatory venous hypertension
- Result of damaged, incompetent valves & venous obstruction
- DVT: Formation of blood clot(s) in deep veins (usually lower extremities), often accompanied by inflammation (thrombophlebitis)
- Anatomic distribution
- Iliofemoral DVT: Includes any part of iliac vein &/or common femoral vein (CFV)
- High incidence of recurrent hospitalizations
- High incidence of postthrombotic venous ulceration
- Femoropopliteal DVT: Involvement limited to popliteal, femoral, &/or deep femoral veins
- Calf DVT: Involves any of paired deep calf veins
- Peroneal, anterior, &/or posterior tibial veins
- Calf DVT does not include popliteal vein
- Iliofemoral DVT: Includes any part of iliac vein &/or common femoral vein (CFV)
- Duration of positive DVT symptoms/imaging tests
- Acute DVT: < 14 days duration
- Subacute DVT: 15-28 days duration
- Chronic DVT: > 28 days duration
- DVT involves left leg 3-5x more than right
- Likely due to May-Thurner anatomy/syndrome
- More severe initial symptoms with iliofemoral compression/occlusion than with more distal DVT
- Much greater likelihood of developing postthrombotic syndrome (PTS)
- Responsible for > 250,000 hospitalizations in USA/year
- Risk factors: Acute medical illness, antiphospholipid syndrome, active cancer, inherited thrombophilia, later age, long-distance travel, major trauma, obesity, oral contraceptives/hormone replacement therapy, paralytic stroke or immobilization, pregnancy, previous VTE, recent surgery, varicose veins
- Anatomic distribution
- Postthrombotic syndrome (PTS): Late DVT sequela
- 20-40% of 1st-time, acute, iliofemoral DVT develop PTS within 2 years
- 5-10% develop severe PTS
- Recurrent ipsilateral DVT associated with 2-6x ↑ risk of PTS
- Result of chronic venous hypertension
- Due to valvular reflux & venous obstruction
- Post-DVT valvular damage leads to reflux
- Thrombosed veins impair venous return
- Due to valvular reflux & venous obstruction
- Severity: Villalta scale of PTS
- Scoring with rating for each sign/symptom of 0 (none), 1 (mild), 2 (moderate), 3 (severe)
- < 5 = no PTS, 5-14 = mild/moderate PTS, ≥ 15 = severe PTS
- Patient symptoms
- Pain (at rest or with ambulation), cramping, heaviness, itching, numbness
- Clinical signs
- Redness, hyperpigmentation, skin induration, venous ectasia, pretibial edema
- Additional signs/symptoms
- Venous claudication, skin lipodermatosclerosis & ulceration, worsening of symptoms with upright position/activity
- Scoring with rating for each sign/symptom of 0 (none), 1 (mild), 2 (moderate), 3 (severe)
- 20-40% of 1st-time, acute, iliofemoral DVT develop PTS within 2 years
- May-Thurner anatomy: Incidental finding; no associated DVT
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Right iliac artery compresses vein against spine
- Occurs near iliac venous confluence into inferior vena cava (IVC)
- Very common finding
- Incidence: Female (41%) > male (27%)
- Rarely symptomatic
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- May-Thurner syndrome: Symptomatic finding; DVT present
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Right iliac artery compresses vein against spine
- Occurs near iliac venous confluence into IVC
- Produces endoluminal fibrous venous scar
- Well seen by intravascular US (IVUS)
- Termed venous "spur" by surgeons & pathologists
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Phlegmasia alba dolens: Massive venous thrombosis-associated lower extremity swelling without cyanosis
- Phlegmasia cerulea dolens: Massive venous thrombosis-associated lower extremity swelling with limb-threatening cyanosis of lower extremity
- Proximal/distal thrombus: Society for Vascular Surgery (SVS) recommends use of precise anatomic terminology (e.g., iliofemoral, femoropopliteal, calf) instead of describing thrombus as proximal/distal
- Report with/without extension into IVC
- Venous thromboembolism (VTE)
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
Society Guidelines
PROCEDURE
Procedure-Specific Goals
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Kutsenko O et al: Iliac vein stenosis: is the data strong enough for stenting in the young pelvic venous disorders (PeVD) population? Tech Vasc Interv Radiol. 24(1):100733, 2021
- Robertson B et al: Technical success and short-term results from mechanical thrombectomy for lower extremity iliofemoral deep vein thrombosis using a computer aided mechanical aspiration thrombectomy device. J Vasc Surg Venous Lymphat Disord. ePub, 2021
- Shah NG et al: Management of inferior vena cava thrombosis with the FlowTriever and ClotTriever systems. J Vasc Surg Venous Lymphat Disord. 9(3):615-20, 2021
- Stevens SM et al: Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 160(6):e545-608, 2021
- Vedantham S et al: Clinical outcomes of a pharmacomechanical catheter-directed venous thrombolysis strategy that included rheolytic thrombectomy in a multicenter randomized trial. J Vasc Interv Radiol. 32(9):1296-1309.e7, 2021
- Benarroch-Gampel J et al: Technical success and short-term outcomes after treatment of lower extremity deep vein thrombosis with the ClotTriever system: a preliminary experience. J Vasc Surg Venous Lymphat Disord. 8(2):174-81, 2020
- Kahn SR et al: Quality of life after pharmacomechanical catheter-directed thrombolysis for proximal deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 8(1):8-23.e18, 2020
- Masuda E et al: The 2020 appropriate use criteria for chronic lower extremity venous disease of the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, and the Society of Interventional Radiology. J Vasc Surg Venous Lymphat Disord. 8(4):505-525.e4, 2020
- Expert Panel on Interventional Radiology: ACR Appropriateness Criteria® radiologic management of venous thromboembolism-inferior vena cava filters. J Am Coll Radiol. 16(5S):S214-26, 2019
- Magnuson EA et al: Cost-effectiveness of pharmacomechanical catheter-directed thrombolysis versus standard anticoagulation in patients with proximal deep vein thrombosis: results from the ATTRACT trial. Circ Cardiovasc Qual Outcomes. 12(10):e005659, 2019
- Chick JFB et al: Endovascular iliocaval reconstruction for chronic iliocaval thrombosis: the data, where we are, and how it is done. Tech Vasc Interv Radiol. 21(2):92-104, 2018
- Shamimi-Noori SM et al: Venous stents: current status and future directions. Tech Vasc Interv Radiol. 21(2):113-6, 2018
- Tritschler T et al: Venous thromboembolism: advances in diagnosis and treatment. JAMA. 320(15):1583-94, 2018
- Mousa AY et al: Catheter-directed thrombolysis versus full anticoagulation alone in treating proximal iliofemoral deep venous thrombosis. Vascular. 25(1):111-2, 2017
- Kearon C et al: Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 149(2):315-52, 2016
- Birn J et al: May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med. 20(1):74-83, 2015
- Comerota AJ: Catheter-directed thrombolysis for iliofemoral deep vein thrombosis: helpful or hurtful? Expert Rev Hematol. 8(2):131-3, 2015
- Du GC et al: Catheter-directed thrombolysis plus anticoagulation versus anticoagulation alone in the treatment of proximal deep vein thrombosis - a meta-analysis. Vasa. 44(3):195-202, 2015
- Vedantham S: Interventional therapy for venous thromboembolism. J Thromb Haemost. 13 Suppl 1:S245-51, 2015
- Kahn SR et al: Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet. 383(9920):880-8, 2014
- Enden T et al: Health-related quality of life after catheter-directed thrombolysis for deep vein thrombosis: secondary outcomes of the randomised, non-blinded, parallel-group CaVenT study. BMJ Open. 3(8):e002984, 2013
- Vedantham S et al: Rationale and design of the ATTRACT study: a multicenter randomized trial to evaluate pharmacomechanical catheter-directed thrombolysis for the prevention of postthrombotic syndrome in patients with proximal deep vein thrombosis. Am Heart J. 165(4):523-530.e3, 2013
- Enden T et al: Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 379(9810):31-8, 2012
- Kearon C et al: Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 141(2 Suppl):e419S-94S, 2012
- Meissner MH et al: Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 55(5):1449-62, 2012
- Broholm R et al: Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis. J Vasc Interv Radiol. 22(6):801-5, 2011
- Chinsakchai K et al: Trends in management of phlegmasia cerulea dolens. Vasc Endovascular Surg. 45(1):5-14, 2011
- Jaff MR et al: Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 123(16):1788-830, 2011
- Karthikesalingam A et al: A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg. 41(4):554-65, 2011
- Khan IR et al: Simultaneous arterial and venous ultrasound-assisted thrombolysis for phlegmasia cerulea dolens. Ann Vasc Surg. 25(5):696, 2011
- Maleti O et al: Reconstructive surgery for deep vein reflux in the lower limbs: techniques, results and indications. Eur J Vasc Endovasc Surg. 41(6):837-48, 2011
- Popuri RK et al: The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol. 31(3):479-84, 2011
- Sarlon G et al: Congenital anomalies of inferior vena cava in young patients with iliac deep venous thrombosis. Ann Vasc Surg. 25(2):265, 2011
- Donati F et al: An uncommon clinical condition: chronic thrombosis of the inferior vena cava. A case report and review of literature. Monaldi Arch Chest Dis. 74(1):36-9, 2010
- Golarz SR et al: Use of Wall stent to exclude a thrombosed inferior vena cava filter. Ann Vasc Surg. 24(5):690, 2010
- Suwanabol PA et al: Syndromes associated with the deep veins: phlegmasia cerulea dolens, May-Thurner syndrome, and nutcracker syndrome. Perspect Vasc Surg Endovasc Ther. 22(4):223-30, 2010
- Muranishi H et al: Thrombo-occlusion of inferior vena cava filter in a patient with polycythemia vera. J Cardiol. 54(2):307-10, 2009
- Wicky ST: Acute deep vein thrombosis and thrombolysis. Tech Vasc Interv Radiol. 12(2):148-53, 2009
- Protack CD et al: Long-term outcomes of catheter directed thrombolysis for lower extremity deep venous thrombosis without prophylactic inferior vena cava filter placement. J Vasc Surg. 45(5):992-7; discussion 997, 2007
- Forauer AR et al: Intravascular ultrasound in the diagnosis and treatment of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 13(5):523-7, 2002
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Post Procedure
Outcomes
TERMINOLOGY
Synonyms
- May-Thurner syndrome = Cockett syndrome, iliac vein or iliocaval compression syndrome
- Femoral vein = superficial femoral vein
Definitions
- Venous thromboembolism (VTE)
- Includes deep vein thrombosis (DVT) & pulmonary embolism (PE)
- Significant source of morbidity & mortality
- Occurs in 1:1,000 people yearly
- Catheter-directed thrombolysis (CDT)
- Delivery of fibrinolytic agent directly into thrombus via intravascular catheter
- Allows ↑ dose of fibrinolytic into thrombus
- ↓ fibrinolytic bypassing thrombus via collaterals
- May ↓ total fibrinolytic dose, treatment/hospitalization time
- Mechanical thrombectomy (MT)
- Removal of thrombus without lytics; removes risk of lytic-related hemorrhage
- Often involves aspiration devices
- Pharmacomechanical thrombolysis (PMT)
- Thrombolytic infusion + mechanical thrombus disruption
- ↑ contact area between fibrinolytic & thrombus
- May improve thrombolytic action, further decreasing fibrinolytic dose & treatment/hospitalization time
- Chronic venous insufficiency (CVI)
- Venous reflux & ambulatory venous hypertension
- Result of damaged, incompetent valves & venous obstruction
- DVT: Formation of blood clot(s) in deep veins (usually lower extremities), often accompanied by inflammation (thrombophlebitis)
- Anatomic distribution
- Iliofemoral DVT: Includes any part of iliac vein &/or common femoral vein (CFV)
- High incidence of recurrent hospitalizations
- High incidence of postthrombotic venous ulceration
- Femoropopliteal DVT: Involvement limited to popliteal, femoral, &/or deep femoral veins
- Calf DVT: Involves any of paired deep calf veins
- Peroneal, anterior, &/or posterior tibial veins
- Calf DVT does not include popliteal vein
- Iliofemoral DVT: Includes any part of iliac vein &/or common femoral vein (CFV)
- Duration of positive DVT symptoms/imaging tests
- Acute DVT: < 14 days duration
- Subacute DVT: 15-28 days duration
- Chronic DVT: > 28 days duration
- DVT involves left leg 3-5x more than right
- Likely due to May-Thurner anatomy/syndrome
- More severe initial symptoms with iliofemoral compression/occlusion than with more distal DVT
- Much greater likelihood of developing postthrombotic syndrome (PTS)
- Responsible for > 250,000 hospitalizations in USA/year
- Risk factors: Acute medical illness, antiphospholipid syndrome, active cancer, inherited thrombophilia, later age, long-distance travel, major trauma, obesity, oral contraceptives/hormone replacement therapy, paralytic stroke or immobilization, pregnancy, previous VTE, recent surgery, varicose veins
- Anatomic distribution
- Postthrombotic syndrome (PTS): Late DVT sequela
- 20-40% of 1st-time, acute, iliofemoral DVT develop PTS within 2 years
- 5-10% develop severe PTS
- Recurrent ipsilateral DVT associated with 2-6x ↑ risk of PTS
- Result of chronic venous hypertension
- Due to valvular reflux & venous obstruction
- Post-DVT valvular damage leads to reflux
- Thrombosed veins impair venous return
- Due to valvular reflux & venous obstruction
- Severity: Villalta scale of PTS
- Scoring with rating for each sign/symptom of 0 (none), 1 (mild), 2 (moderate), 3 (severe)
- < 5 = no PTS, 5-14 = mild/moderate PTS, ≥ 15 = severe PTS
- Patient symptoms
- Pain (at rest or with ambulation), cramping, heaviness, itching, numbness
- Clinical signs
- Redness, hyperpigmentation, skin induration, venous ectasia, pretibial edema
- Additional signs/symptoms
- Venous claudication, skin lipodermatosclerosis & ulceration, worsening of symptoms with upright position/activity
- Scoring with rating for each sign/symptom of 0 (none), 1 (mild), 2 (moderate), 3 (severe)
- 20-40% of 1st-time, acute, iliofemoral DVT develop PTS within 2 years
- May-Thurner anatomy: Incidental finding; no associated DVT
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Right iliac artery compresses vein against spine
- Occurs near iliac venous confluence into inferior vena cava (IVC)
- Very common finding
- Incidence: Female (41%) > male (27%)
- Rarely symptomatic
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- May-Thurner syndrome: Symptomatic finding; DVT present
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Right iliac artery compresses vein against spine
- Occurs near iliac venous confluence into IVC
- Produces endoluminal fibrous venous scar
- Well seen by intravascular US (IVUS)
- Termed venous "spur" by surgeons & pathologists
- Left iliac vein compressed obliquely & anteriorly by right iliac artery
- Phlegmasia alba dolens: Massive venous thrombosis-associated lower extremity swelling without cyanosis
- Phlegmasia cerulea dolens: Massive venous thrombosis-associated lower extremity swelling with limb-threatening cyanosis of lower extremity
- Proximal/distal thrombus: Society for Vascular Surgery (SVS) recommends use of precise anatomic terminology (e.g., iliofemoral, femoropopliteal, calf) instead of describing thrombus as proximal/distal
- Report with/without extension into IVC
- Venous thromboembolism (VTE)
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
Society Guidelines
PROCEDURE
Procedure-Specific Goals
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Kutsenko O et al: Iliac vein stenosis: is the data strong enough for stenting in the young pelvic venous disorders (PeVD) population? Tech Vasc Interv Radiol. 24(1):100733, 2021
- Robertson B et al: Technical success and short-term results from mechanical thrombectomy for lower extremity iliofemoral deep vein thrombosis using a computer aided mechanical aspiration thrombectomy device. J Vasc Surg Venous Lymphat Disord. ePub, 2021
- Shah NG et al: Management of inferior vena cava thrombosis with the FlowTriever and ClotTriever systems. J Vasc Surg Venous Lymphat Disord. 9(3):615-20, 2021
- Stevens SM et al: Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 160(6):e545-608, 2021
- Vedantham S et al: Clinical outcomes of a pharmacomechanical catheter-directed venous thrombolysis strategy that included rheolytic thrombectomy in a multicenter randomized trial. J Vasc Interv Radiol. 32(9):1296-1309.e7, 2021
- Benarroch-Gampel J et al: Technical success and short-term outcomes after treatment of lower extremity deep vein thrombosis with the ClotTriever system: a preliminary experience. J Vasc Surg Venous Lymphat Disord. 8(2):174-81, 2020
- Kahn SR et al: Quality of life after pharmacomechanical catheter-directed thrombolysis for proximal deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 8(1):8-23.e18, 2020
- Masuda E et al: The 2020 appropriate use criteria for chronic lower extremity venous disease of the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, and the Society of Interventional Radiology. J Vasc Surg Venous Lymphat Disord. 8(4):505-525.e4, 2020
- Expert Panel on Interventional Radiology: ACR Appropriateness Criteria® radiologic management of venous thromboembolism-inferior vena cava filters. J Am Coll Radiol. 16(5S):S214-26, 2019
- Magnuson EA et al: Cost-effectiveness of pharmacomechanical catheter-directed thrombolysis versus standard anticoagulation in patients with proximal deep vein thrombosis: results from the ATTRACT trial. Circ Cardiovasc Qual Outcomes. 12(10):e005659, 2019
- Chick JFB et al: Endovascular iliocaval reconstruction for chronic iliocaval thrombosis: the data, where we are, and how it is done. Tech Vasc Interv Radiol. 21(2):92-104, 2018
- Shamimi-Noori SM et al: Venous stents: current status and future directions. Tech Vasc Interv Radiol. 21(2):113-6, 2018
- Tritschler T et al: Venous thromboembolism: advances in diagnosis and treatment. JAMA. 320(15):1583-94, 2018
- Mousa AY et al: Catheter-directed thrombolysis versus full anticoagulation alone in treating proximal iliofemoral deep venous thrombosis. Vascular. 25(1):111-2, 2017
- Kearon C et al: Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 149(2):315-52, 2016
- Birn J et al: May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med. 20(1):74-83, 2015
- Comerota AJ: Catheter-directed thrombolysis for iliofemoral deep vein thrombosis: helpful or hurtful? Expert Rev Hematol. 8(2):131-3, 2015
- Du GC et al: Catheter-directed thrombolysis plus anticoagulation versus anticoagulation alone in the treatment of proximal deep vein thrombosis - a meta-analysis. Vasa. 44(3):195-202, 2015
- Vedantham S: Interventional therapy for venous thromboembolism. J Thromb Haemost. 13 Suppl 1:S245-51, 2015
- Kahn SR et al: Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial. Lancet. 383(9920):880-8, 2014
- Enden T et al: Health-related quality of life after catheter-directed thrombolysis for deep vein thrombosis: secondary outcomes of the randomised, non-blinded, parallel-group CaVenT study. BMJ Open. 3(8):e002984, 2013
- Vedantham S et al: Rationale and design of the ATTRACT study: a multicenter randomized trial to evaluate pharmacomechanical catheter-directed thrombolysis for the prevention of postthrombotic syndrome in patients with proximal deep vein thrombosis. Am Heart J. 165(4):523-530.e3, 2013
- Enden T et al: Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 379(9810):31-8, 2012
- Kearon C et al: Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 141(2 Suppl):e419S-94S, 2012
- Meissner MH et al: Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 55(5):1449-62, 2012
- Broholm R et al: Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis. J Vasc Interv Radiol. 22(6):801-5, 2011
- Chinsakchai K et al: Trends in management of phlegmasia cerulea dolens. Vasc Endovascular Surg. 45(1):5-14, 2011
- Jaff MR et al: Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 123(16):1788-830, 2011
- Karthikesalingam A et al: A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg. 41(4):554-65, 2011
- Khan IR et al: Simultaneous arterial and venous ultrasound-assisted thrombolysis for phlegmasia cerulea dolens. Ann Vasc Surg. 25(5):696, 2011
- Maleti O et al: Reconstructive surgery for deep vein reflux in the lower limbs: techniques, results and indications. Eur J Vasc Endovasc Surg. 41(6):837-48, 2011
- Popuri RK et al: The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol. 31(3):479-84, 2011
- Sarlon G et al: Congenital anomalies of inferior vena cava in young patients with iliac deep venous thrombosis. Ann Vasc Surg. 25(2):265, 2011
- Donati F et al: An uncommon clinical condition: chronic thrombosis of the inferior vena cava. A case report and review of literature. Monaldi Arch Chest Dis. 74(1):36-9, 2010
- Golarz SR et al: Use of Wall stent to exclude a thrombosed inferior vena cava filter. Ann Vasc Surg. 24(5):690, 2010
- Suwanabol PA et al: Syndromes associated with the deep veins: phlegmasia cerulea dolens, May-Thurner syndrome, and nutcracker syndrome. Perspect Vasc Surg Endovasc Ther. 22(4):223-30, 2010
- Muranishi H et al: Thrombo-occlusion of inferior vena cava filter in a patient with polycythemia vera. J Cardiol. 54(2):307-10, 2009
- Wicky ST: Acute deep vein thrombosis and thrombolysis. Tech Vasc Interv Radiol. 12(2):148-53, 2009
- Protack CD et al: Long-term outcomes of catheter directed thrombolysis for lower extremity deep venous thrombosis without prophylactic inferior vena cava filter placement. J Vasc Surg. 45(5):992-7; discussion 997, 2007
- Forauer AR et al: Intravascular ultrasound in the diagnosis and treatment of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 13(5):523-7, 2002
