My right leg has been swollen for 9 months now. I had rf ablation to close the greater saphenous veins, but my leg is still swollen. I've had all normal ultrasounds and a CT scan that was normal. My new vein Dr. thinks it's May Thurner syndrome. I was on the pill for 25 years. I know it's a rare condition and even more rare in the right leg, but could I have MTS with no blood clots or DVT?
It is possible to have compression of the right iliac vein by the artery, although rare. To really know if there is a narrowing, would involve an invasive procedure and using ultrasound inside the vein to look for compression or scarring.
Published on Jul 11, 2012
The most common symptom related to May-Thurner Syndrome is leg swelling. You certainly can have right side MTS without DVT or clots. A routine CT may now show MTS. What you would need is a CTA with venous phase or MRV.
Published on Jul 11, 2012
Yes May-Thurner syndrome can manifest in degrees. You can have partial obstruction without developing blood clots. A doctor that can perform IVUS, intravenous Ultrasound can determine whether or not you are afflicted with this and if so can stent the vein to open it back to patency.
Published on Jul 11, 2012
It is possible to have MTS with out DVT. You are correct that it usually is on the left side, but compression can occur on the right side. I would be very careful to get a proper diagnosis that shows you truly have MTS, otherwise they will place a stent unnecessarily. Swelling improves in about 50% of patients after stenting for MTS.
Published on Jul 11, 2012
You can have May-Thurner syndrome without blood clots, however I have never heard of it in the Right leg. May-Thurner as you probably know is a compression of the left iliac vein between the left iliac artery and bones of the hip/pelvis. Anatomically the right leg can't have that due to the way your anatomy is set up. I suppose you can have vein obstruction from somethimg else in the right iliac vein.
Regardless a venogram or MR or CT venogram would have seen proximal obstruction in the pelvis so if that was negative then consider lymphedema for which treatment is physical therapy.
Published on Jul 11, 2012