It results from extrinsic compression of left iliac vein
by an anomalous overlying right iliac artery which predisposes to deep venous thrombosis.
3a) and patent infrarenal IVC and bilateral iliac veins
with some residual thrombus about the IVC filter and in the right lower extremity veins distal to the renal allograft vessels (Fig.
External iliac vein
: This is the continuation of the femoral vein above the inguinal ligament and runs on the posterior side of the external iliac artery.
However, magnetic resonance venogram (MRV) of pelvis showed compression of the left common iliac vein
just after its origin, which was suggestive of May-Thurner syndrome (Figure 1).
compression syndrome (IVCS), also known as May–Thurner syndrome or Cockett syndrome, is characterized by left common iliac vein
(LCIV) compression by the right iliac artery (RIA) and the fifth lumbar vertebra.
Transplant surgeons should be informed of all patients on the waiting list with current or previous catheters beyond the common iliac vein
confluence (or within both external iliac veins
) for more than 30 cumulative days, as difficult transplantation should be anticipated.
Lee, "Anatomical variations of the internal iliac veins
in the presacral area: clinical implications during sacral colpopepxy or extended pelvic lymphadenectomy," Clinical Anatomy, vol.
One feature is the excessive thrombosis of the vena cava extending into both iliac veins
. As documented in the present patient, such events are pathogenetically associated with abdominal metastases compressing the vena cava, reducing blood flow velocity, and thus precipitating intravascular clotting [19-21].
Of note, all described patients with Noonan syndrome and agenesis of the ductus venosus (including the current case) have had direct umbilical drainage into the iliac veins
Also, this diagnostic view demonstrated etiologic background of patient nonevoked extensive DVT which was significant stenosis of common iliac vein
Venous Doppler echography showed thrombosed left common femoral vein, thrombosed external and internal iliac veins
with hypoechoic thrombus, inferior vena cava identified only at the origin, with reduced caliber, permeable right venous axis.
Extensive bland tumour thrombus was present within the cava and iliac veins
below the tumour.