Dr. Sudi Explains...May Thurner Syndrome

Dr. Sudi explains in an easy to understand way what May Thurner Syndrome (MTS) is and how it is treated. MTS affects the LEFT leg only and should be considered in any person with extensive blood clots in the left leg, unexplained swelling of the entire left leg, or chronic pelvic pain.
If you found this video helpful, please leave a comment!
#DVT #bloodclot #womenshealth #menshealth #vascularsurgery #interventionalradiology #vascular #pelvicpain #patientcare #patienteducation #columbusohio #hematology #emergencymedicine

[@miamullins673]

Best explanation ever for common people!

[@DrSudi]

Thank you! I'm glad you found it informative.

[@annettewhite8430]

Thank you daddy❤

[@sanelazulic5038]

wow this is so informative! I was treated for pelvic congestion syndrome about 3 weeks ago after suffering for 5 years with a variety of symptoms that were all treated as muscular or ortho issues. They were none of those things. I followed up with my vascular surgeon today who wanted to give me time to recover from coiling procedure for my pcs and discuss possible future pregnancy with my husband before giving me the news today that I also have this syndrome where both sides are 70-80 percent blocked from scar tissue. Im glad she gave me the time to recoverand consider family goals before deciding to put in stents. Since pregnancy and stent carry additional risks. I dont know if I was born with this issue or developed it over time but thank you for the video. Praying all goes well. Wanted to comment to share my experience and hope others continue to benefit from your video. Very well explained!

[@DrSudi]

Thank you for your comments. I'm so glad that you found the information educational.

[@jillburan2343]

after hearing this, I'm pretty positive I was not a candidate for a stent, but received one in 2015. I have had nothing but problems since the placement... back/hip/upper thigh leg pain. I am now in pain management because of this because it is a difficult procedure to remove the stent.

[@Floodland-bn3ol]

Sorry to hear this. May I ask if the stent was in your Iliac Vein? Did you have DVT clots in the leg? Thanks

[@breejeanne]

So well done!! Please do Nutctacker Syndrome, thats what i was recently diagnosed with. Its SO painful!

[@taylorwu2266]

I have Bilateral MTS, severe PCS, AND Nutcracker syndrome 😣 accompanied by Ehlers-Danlos as well as many many other chronic/rare conditions. Having another venogram soon to evaluate if Nutcracker is borderline and not significant enough or if it’s gotten worse and it’s time to do something. It’s awful. Thank you for this video. I’ve had to educate so many of my specialists.

[@888dope888]

do you suffer from erectile problems as well?

[@Nothingggggggggghggg]

I have similar things including slipping ribs, did you get the surgery finally?

[@bettyweimer394]

Best explanation of Mae Thurner Syndrome I’ve heard! I was diagnosed by my Cardiologist; no blood clot then! Leg very swollen and painful! My Dr did a venogram and placed a stent! Swelling and pain gone in less than a week! I hope it continues to do well! Great explanation Dr. Sudi!

[@DrSudi]

Thank you. I'm thrilled to hear that you are doing well and got the help that you need. I'm glad that you found the video informative.

[@bettyweimer394]

Since then I had to go to ER with AFib and blood clots_ Cardiologist doing another procedure on my vein(s) a week from today!???? I sure hope I am on the right path!,,..

[@MarjorieMayo-cb3ir]

So very informative. I was wondering if I actually needed a stent but after listening to this, I'm confident that it was needed.

[@bettyweimer394]

Very good explanation! Clearly explained!

[@AnthonyThe6reat]

Excellent video, seeing a cardiovascular surgeon tomorrow due to a compression seen on my MRV. I do in fact have symptoms, looks like I mostly have may thurners and will need the stent.

[@Floodland-bn3ol]

Great explanation. Thank-you

[@MaryAllen-cq6xy]

Thank you for easy to understand explanation. Great speaker, great tone, great pace

[@natashak3387]

Thank you for this video! I am having another Venogram by my IR Doctor soon. I was stented and had life saving procedures in 2015 for MTS and large history of clots. I have been having complications with my health and hopefully this next venogram will give more answers. My goal is to come off Eliquis eventually since I have been on blood thinners for years. My Doctor might be able to get me switched to Aspirin. Thanks again !

[@michellebinder5131]

I have 9 1/2” of stents (3) in my left iliac vein. I had very quick relief. My left thigh was 43” around, it’s normally 20-22”. I did have a DVT. I also ended up with 5 pulmonary embolisms in my left lung. I am a lifer on Warfarin. I notice when I look at myself in the mirror that my left pelvic area is puffy looking, my right side looks caved in. I’m glad I got the stents.

[@mistycounts6100]

Very well explained and understanding .

[@natashak3387]

My May Thurner Syndrome is causing internal hemroids, bleeding, severe anemia requiring months of iron infusions, and more.

[@janicejacome]

Wow l have ALL THESE, but my local hospital says NO! I also get a numbing, burning sensation in bikini area if l stand awhile without walking. Wishing you well! I also have 4ever stomach issues chalked up to hiatal hernia but NON STOP WORSENING BURPING is 😢. My IVC filter ( found out looking at ❤!) is poking my small intestine on one side n my aorta on other!!) Don't know where to start! Definitely not hospital l was at before! Better health to us all. Wish he was my doc!!!

[@allycharara2397]

Great video, Dr. Sudi! Very informative

[@DrSudi]

Thank you! I'm glad you found it educational.

[@DarkAngel-cj6sx]

Thank you so much.

[@DrSudi]

Glad you found it helpful!

[@lidvinakim1193]

Hi Dr Sudi, first of all thank you for the great informative video! I found it extremely fascinating that the pulsation of the iliac artery can lead to scar tissue inside the iliac vein. Can I please ask if there is any article that you have written on this and also about considering angiography that I can read more on? And is there a way to check for scar tissues? My doctor declined stent surgery because I am too young however I have pelvic congestion syndrome and I have been bedridden for the past 6months due to pain.. Thank you for all the amazing work you are doing for people like me that suffer

[@jhellier]

Excellent summary and presentation. Is it possible to see scar tissue on duplex ultrasound (not IVUS)? My VS says I have no scarring but I have only done duplex ultrasound. Also, if it possible to cure MTS by placing Wallstent then removing a year later? I know syndrome who had this procedure done recently. I heard self-dissolving stents had issues with structural integrity on expansion. Do you see hope for improved versions in the future? Thanks for your time.

[@BRAHHHHHH]

In my case my stent has been misplaced and is excessively protruding into my vena cava and I now also have the same MTS symptoms in my right leg also. My left is worsening without any relief from the stent whatsoever

[@jennifermcdonald5806]

Thanks for the great video! I have MTS, Factor V leiden, history of left DVT that started in the groin when pregnant, but never knew all the information you have just talked about MTS! Can anything show how much scar tissue is in the vein or is it just looking at symptoms? Thanks for the great emails and videos!

[@DrSudi]

Great question Ms. McDonald. Intravascular ultrasound (IVUS) can show scar tissue very well. This is a catheter that has an ultrasound at its tip. The catheter is inserted into the blood vessel and the IVUS shows us what's going on inside the blood vessel. My blog article below provides more info that may be useful. www.gethealthyveins.com/2021/10/31/the-patients-guide-to-may-thurner-syndrome-questions-to-ask-your-physician-before-getting-a-stent/

[@DrSudi]

Glad you found it helpful!

[@jennfun1974]

Hello dr. I had my first DVT in 2004. Was on Coumadin until 2014 when I had an ischemic stroke was on 30 mg , my inr was 4.7. Since 2016 I’ve had TWELVE bouts of chronic unprovoked bilateral PE. The past three months I’ve been hospitalized for fainting spells with peripheral leg swelling and abnormalities on ekg. SOB, RBBB, . Had right side heart cath and ct w/wo contrast of pelvis. Images show some compression of Iliac. I have ridiculous amounts of pain and burning in both ankles and feet but my right leg has always been significantly larger than left. This time around I had another DVT in left leg . They are 90% of the time found in my lungs. I have also just been diagnosed with significant pulmonary hypertension and right side heart failure . Going June 3 for mts stent

[@DrSudi]

Oh my goodness! I hope you get the help you need and that the underlying cause of your symptoms is found and treated. Best of luck to you! -- Dr. Sudi

[@phoebe8821]

You mention in your video and in the description box that May-Thurner's Syndrome affects the left side only. What are your thoughts on ride side only MTS or even bilateral presentations of MTS? I've seen some journal papers of other variants of MTS, but I am not sure if it is still called MTS at that point or if those cases would go by some other name. Would be great to see a video on this! This current video was great and well organized. I learned a lot!

[@DrSudi]

MTS can affect the right leg but we don't call it MTS. If the right iliac vein is compressed, it is referred to as iliac vein compression syndrome which is the general category. MTS is specific to the left common iliac vein because it was initially discovered by Drs. May and Thurner on the left side. Often when the right common iliac vein is compressed, it is compressed by the right common iliac artery. In fact, depending on the angle that the right common iliac artery has, it can compress both the left and right common iliac veins. Read my blog article on this topic. Dr. Sudi www.gethealthyveins.com/2021/01/13/can-may-thurner-syndrome-cause-symptoms-in-both-legs/

[@serenagriffith165]

What about for people who have stents for MTS and Left Renal Vein compression. And the stents are compressed after a few months? And then more angioplasty have to take place to reopen the stents?

[@monaalzghoul3383]

Hi dr i have pcs I had 4 embolization my symptoms in pelvic and right side and my leg I don’t have nutcracker syndrome or compression is there any reason to have my thornier syndrome

[@mangeshtarte8511]

R/Sir, Very Nice Video talk And scientific info in lucid language provided to Common people. My Simple question is that How to convince patient & relatives that it’s Vein is damaged due to a Compression of Pulsatile overlying Common iliac artery Not the Spine or Vertebra or Intervertebral disc prolapse (PID) caused Vein luminal narrowing + Scar tissues? In India, due to easy availability of MRI Scans & Neuro + Ortho surgeons; Laminectomy or Endoscopic disketomy performed for MTS Deep Venous Diseases. How to explain these real facts to operated Patients??

[@DrSudi]

Excellent question Dr. Tarte. Unfortunately, I don't have a great answer for you. Personally, I think pictures speak a thousand words and so I draw a lot of pictures or bring up images on google during my patients consultations. I make sure that I explain things clearly and in a very simply way so that patients understand and the pictures back up my explanation. Sometimes I use actual models of the pelvis and bring in a stent for them to hold so that they can get a better understanding of the condition and the treatment.

[@shelby2u]

Hi Dr Sudi Is there anything else that can be done for CVI and MTS? Been dealing with it for years, discovered DVT and MTS in 2013, and I want my energy back. Play tennis, go dancing, play basketball, golf or whatever. I want to ge back to living a fun life. Thank you for any insite you can give, Marla Ahlquist

[@DrSudi]

If your iliac vein in your pelvic and femoral vein in your leg are blocked from prior DVT, then the veins can be reopened and the scar tissue broken up with a procedure known as deep venous recanalization (DVR). It can provide significant improvement in QOL. While it does not work for everyone, in my experience the vast majority of patients do see significant improvement. You can read more about it at www.gethealthyveins.com/2021/12/05/deep-vein-recanalization-for-the-treatment-of-post-thrombotic-syndrome/

[@shelby2u]

@@DrSudi Thank You so much.. OK Reading now. Yes I have had 2 DVT's 2013 & 2021. After the first one, it took 6 months but I bounced back. This last one took it out of me and I need to rest my leg more. I am a gal that keeps stats on my leg so I know how I am doing and this way I can see trends on my swelling. Yes my VS reads my leg reports and he likes that I am very focused on my heath and healing. Thank you again, Marla

[@samuelnantos1482]

Hi dr im having severe swelling pain and tightness in my left ankle and lower leg can this still be mts?

[@janabrewer7150]

I had my first DVT at 18.. Two years ago at 43, I was FINALLY diagnosed with May-Thurner after my PE. One doctor came in, and immediately said it and by goodness, she was right. Now I have a stent and the pain is still intense, my leg still swells and now I have to have a reflux test because I have a wound on my ankle that won't heal. I know that this is a progressive disease, will I eventually just lose my leg? My doctor said it's a possibility.😞

[@DrSudi]

It's hard for me to comment on your specific situation but it is rare for a patient to lose their leg from MTS. If you did not get any benefit from the stent, it may be because the vein ALL THE WAY down the leg to the ankle were not opened. This is a procedure known as deep vein recanalization. You can read more about it on my blog gethealthyveins.com. There is also a lot of info about MTS on this blog. www.gethealthyveins.com/2021/12/05/deep-vein-recanalization-for-the-treatment-of-post-thrombotic-syndrome/

[@janabrewer7150]

@@DrSudi thank you so much!! I really appreciate that and I'm going to read about it now!

[@metalmama007]

What if you have horrible symptoms, pelvic congestion syndrome with hemorrhoids and bleeding, but not much shows on a regular abdominal CT. No venogram done.

[@DrSudi]

Just because a CT/MRI doesn't show anything, does not mean that one does not have MTS/PCS. In addition to a very thorough history and physical exam, the catheter venogram is crucial. If that is also negative, then other causes of the symptoms need to be considered.

[@danaharel9200]

Thank you so much for this vedio! How can I connect you plz?

[@DrSudi]

Glad you found the video helpful!

[@TonicCantaloupe]

Hi, Im 30 and they confirmed I have MTS and placed about 10cm of stents in my iliac vein. I really dont like having the stent, because I dont want to be on accompanying blood thinners for life. I have found through some research that there are surgical options to: move the artery, bypass, or a tissue sling. Can yo provide some thoughts and information on the effectiveness and safety of these surgical options?

[@miamullins673]

Stents are more often done in the states. The other surgery is more often done in Europe. We took my daughter to Thomas Scholbach in Germany. Google him. His associate that does the surgery is Dr sandman

[@lucymendoza84]

Would all three of those conditions need to be present to consider stenting? If only severe PVI (pelvic pain, back pain, left leg pain but no swelling or DVT) and May Thurner compression are present would it be appropriate to embolize for PVI rather than stenting for the cause which is May Thurner?

[@DrSudi]

That's a good question. However, it can only be answered after a thorough examination and after doing a diagnostic venogram. Other testing such as a standing reflux ultrasound also needs to be done as that can be a cause of left leg pain which would then factor into the whole equation of whether to stent or embolize.

[@dju324]

Dr Sudi, weren't most stent recalls due to improper placement?

[@DrSudi]

There were a couple stents recalled due to migration and also a faulty deployment system. Personally, I think that the stents were not placed properly but I don't know for sure. This underscores that experience counts! You can have the best stent in the world and if it is not placed properly, there will be problems.

[@YaGirlMubs]

PLEASE READ & PLEASE HELP!!!! Hello i have a serious question. My sister has been diagnosed with May Thurner syndrome and they have told her that she needs a stent put in but the problem is that she is highly allergic to the metal that the stent is made of! So as of now there is nothing that can be done. Unless someone out there reading this can make a miracle happen!?!?

[@DrSudi]

This is an issue that requires a consultation with a vascular specialist. Not all metal allergies are the same which is why it's important for your sister to see an expert. Best of luck to her!

[@picturesbymaggie]

Hi, any downside or side effects from angioplasty?

[@DrSudi]

The only downside is that angioplasty alone may not work. No harm no foul. If it doesn't work then a stent is likely needed. However, there are only certain cases where I think angioplasty alone should be tried and this requires an in-depth discussion with your vascular specialist. Hope this helps! -- Dr. Sudi

[@joypaul7836]

𝓅𝓇o𝓂o𝓈𝓂 😏