Treatment
Management of the underlying defect is imperative to preventing further exacerbations and aggravation of the underlying malformation. Patients with May–Thurner syndrome may require an angioplasty of the iliac vein. Generally a braided stainless steel stent is used to support the area from further compression following angioplasty. In the 21st century ambulatory patients with significant symptoms affecting Quality of Life are increasingly having the Non-thrombotic Iliac Vein Lesions treated with angioplasty as well as stent placement. As the name implies there is not a thrombotic component in these cases.
If the patient has extensive thrombosis, it may be prudent to consider pharmacologic and/or mechanical (also known as pharmacomechanical) thrombectomy to decrease the incidence of post-thrombotic syndrome. At the time of the thrombectomy the use of an inferior vena cava filter may be considered to prevent pulmonary embolism in these patients although filter use continues to evolve and will not correct the underlying lesion alone.
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