May-Thurner syndrome: High output cardiac failure as a result of iatrogenic iliac fistula
May-Thurner syndrome: High output cardiac failure as a result of iatrogenic iliac fistula作者机构：Department of Medicine University of Illinois College of Medicine at Peoria Department of Medicine Southern Medical University Division of Pulmonology Duke LPMP 27536United States
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2015年第3卷第3期
页 面：318-321页
核心收录：
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：May-Thurner syndrome Cardiac failure Echocardiogram Cockett-Thomas syndrome Iliocaval compression
摘 要：May-Thurner syndrome(MTS) also termed iliocaval compression or Cockett-Thomas syndrome is a common, although rarely diagnosed, condition in which the patient has an anatomical variant wherein theright common iliac artery overlies and compresses the left common iliac vein against the fifth lumbar spine resulting in increased risk of iliofemoral deep venous thrombosis. This variant has been shown to be present in over 23% of the population but most go undetected. We present a patient with MTS who developed high output cardiac failure due to an iatrogenic iliac fistula. The patient underwent an extensive workup for a left to right shunt including MRI and arterial duplex in the vascular lab. He was ultimately found to have a 2.1 cm left common iliac artery aneurysm and history of common iliac stent. We took the patient to the operating room for aortogram with placement of an endovascular plug of the left internal iliac artery and aorto-biiliac stent graft placement with CO2 and Ⅳ contrast. Subsequently the patient underwent successful stent placement in the area that was compressed followed by 6 mo of anticoagulation with warfarin. The flow from the fistula decreased significantly.
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