Would 2 Doppler ultrasounds find any leg clots? (Thigh or calf). Is May Thurners Syndrome possible and a venography necessary in my case?
I've had swelling in my left ankle and calf for a few years. Pain for a few months in calf, and sometimes whole leg, but not when I walk. occasional tingling. I’ve had 2 ultrasounds on both legs a month apart— 1 while standing and 1 while laying down with the table tilted. No clots were found but some mild veneous insufficiency. the sugested treatment was wearing compression stockings for 6 weeks to see if it helps. May Thurner Syndrome was mentioned and the clinic wants to do a venography.
Answers from doctors (2)
Ultrasound is the most accurate way to find clots. So you likely have none. Yes, if your doctor recommends you be assessed for May Thurners, you should proceed with it.
Published on Jul 11, 2012
May-Thurner syndrome occurs when the left common iliac vein is compressed by the anteriorly crossing right common iliac artery against the lumbar spine (L5). There may be enough compression to cause obstruction of the venous flow out of your left leg and thigh and rerouting of blood through a variety of channels. Patients may complain of pelvic pain, pain with intercourse (deep and lasting a while afterward), buttock pain which is worse with sitting or standing and may radiate as an achiness down the posterior thigh toward the back of the knee. Venography per se is not very accurate as making the diagnosis. Intravascular ultrasound (IVUS) is the gold standard for making the definitive diagnosis, and venography is usually part of this case and may demonstrate cross pelvic collaterals, but is not the critical part in identifying the precise location and severity of the blockage. Your next step in my opinion would be to seek out a vein specialist with experience with all aspects of venous disease evaluation and management and request an evaluation. You can also research May Thurner and see if you have the classic signs or symptoms and try to grade the severity of your symptoms to determine whether you have enough to proceed further.
Published on Jul 11, 2012
