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Virchow in 1851 noted that iliofemoral venous thrombosis is more common on the left side. May and Thurner in 1957 described left common iliac vein intraluminal bands resulting from mechanical obstruction by the right common iliac artery. The typical patient with May-Thurner syndrome has left lower extremity pain and swelling, resulting in varicosities, phlebitis, deep venous thrombosis, venous stasis dermatitis, and pulmonary embolism. Imaging demonstrates narrowing of the caliber of the left common iliac vein as it passes between the right common iliac artery and the spine. Symptomatic patients also have evidence of collateral venous circulation.

Examples (click on images)


  1. Fraser DG, Moody AR, Martel A, Morgan PS. Re-evaluation of iliac compression syndrome using magnetic resonance imaging in patients with acute deep venous thromboses. J Vasc Surg 2004; 40:604-611. PubMed link
  2. Suwanabol PA, Tefera G, Schwarze ML. Syndromes associated with the deep veins: phlegmasia cerulea dolens, May-Thurner syndrome, and nutcracker syndrome. Perspect Vasc Surg Endovasc Ther 2010; 22:223-230. PubMed link
  3. O'Sullivan GJ, Semba CP, Bittner CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol 2000; 11:823-836. PubMed link