Venous compression syndromes occur due to extrinsic compression causing complications of venous hypertension or venous thrombosis. This review focuses on 4 venous compression syndromes involving the left common iliac vein, subclavian vein, left renal vein, and popliteal vein. Clinical presentation, diagnostic methods, and management options are reviewed. When properly diagnosed and treated, long-term consequences can be avoided.
EliahouRSosnaJBloomAI. Between a rock and a hard place: clinical and imaging features of vascular compression syndromes. Radiographics. 2012;32(1):E33–E49.
VirchowR. Uber die Erweiterung kleiner Gafasse. Arch Path Anat. 1851;(3):427.
4.
McMurrichJP. The occurrence of congenital adhesions in the common iliac veins, and their relation to thrombosis of the femoral and iliac veins. Am J Med Sci. 1908;135(3):342-346.
5.
MayRThurnerJ. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8(5):419–427.
6.
MousaAYAbuRahmaAF. May-Thurner syndrome: update and review. Ann Vasc Surg. 2013;27(7):984–995.
7.
KibbeMRUjikiMGoodwinALEskandariMYaoJMatsumuraJ. Iliac vein compression in an asymptomatic patient population. J Vasc Surg. 2004;39(5):937–943.
8.
NazzalMEl-FedalyMKazanV. Incidence and clinical significance of iliac vein compression. Vascular. 2015;23(4):337–343.
9.
DeRubertisBGAlktaifiAJimenezJCRigbergDGelabertHLawrencePF. Endovascular management of nonmalignant iliocaval venous lesions. Ann Vasc Surg. 2013;27(5):577–586.
10.
KiernanTJYanBPCubedduRJ. May-Thurner syndrome in patients with cryptogenic stroke and patent foramen ovale: an important clinical association. Stroke. 2009;40(4):1502–1504.
11.
GreerDMBuonannoFS. Cerebral infarction in conjunction with patent foramen ovale and May-Thurner syndrome. J Neuroimaging. 2001;11(4):432–434.
12.
BirnJVedanthamS. May-Thurner syndrome and other obstructive iliac vein lesions: meaning, myth, and mystery. Vasc Med. 2015;20(1):74–83.
13.
LabropoulosNBorgeMPierceKPappasPJ. Criteria for defining significant central vein stenosis with duplex ultrasound. J Vasc Surg. 2007;46(1):101–107.
NeglenPRajuS. Intravascular ultrasound scan evaluation of the obstructed vein. J Vasc Surg. 2002;35(4):694–700.
18.
NeglenPHollisKCOlivierJRajuS. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg. 2007;46(5):979–990.
19.
ForauerARGemmeteJJDasikaNLChoKJWilliamsDM. Intravascular ultrasound in the diagnosis and treatment of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2002;13(5):523–527.
20.
SatokawaHHoshinoSIwayaFIgariTMidorikawaHOgawaT. Intravascular imaging methods for venous disorders. Int J Angiol. 2000;9(2):117–121.
21.
ComerotaAJThromRCMathiasSDHaughtonSMewissenM. Catheter-directed thrombolysis for iliofemoral deep venous thrombosis improves health-related quality of life. J Vasc Surg. 2000;32(1):130–137.
22.
ComerotaAJGrewalNMartinezJT. Postthrombotic morbidity correlates with residual thrombus following catheter-directed thrombolysis for iliofemoral deep vein thrombosis. J Vasc Surg. 2012;55(3):768–773.
23.
EndenTHaigYKlowNE; CaVenT Study Group. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 2012;379(9810):31–38.
HartungOOteroABoufiM. Mid-term results of endovascular treatment for symptomatic chronic nonmalignant iliocaval venous occlusive disease. J Vasc Surg. 2005;42(6):1138–1144.
27.
HartungOBenmiloudFBarthelemyPDubucMBoufiMAlimiYS. Late results of surgical venous thrombectomy with iliocaval stenting. J Vasc Surg. 2008;47(2):381–387.
28.
HusmannMJHellerGKalkaC. Stenting of common iliac vein obstructions combined with regional thrombolysis and thrombectomy in acute deep vein thrombosis. Eur J Vasc Endovasc Surg. 2007;34(1):87–91.
29.
KölbelTLindhMHolstJ. Extensive acute deep vein thrombosis of the iliocaval segment: midterm results of thrombolysis and stent placement. J Vasc Interv Radiol. 2007;18(2):243–250.
30.
HughesES. Venous obstruction in the upper extremity; Paget-Schroetter’s syndrome; a review of 320 cases. Surg Gynecol Obstet. 1949;88(2):89–127.
31.
IlligKADoyleAJ. A comprehensive review of Paget-Schroetter syndrome. J Vasc Surg. 2010;51(6):1538–1547.
32.
SandersRJHammondSL. Venous thoracic outlet syndrome. Hand Clin. 2004;20(1):113–118, viii.
33.
SchneiderDBAzakieAMessinaLMStoneyRJ. Management of vascular thoracic outlet syndrome. Chest Surg Clin N Am. 1996;(9):781–803.
34.
DoyleAWolfordHYDaviesMG. Management of effort thrombosis of the subclavian vein: today’s treatment. Ann Vasc Surg. 2007;21(6):723–729.
35.
AdamsJTDeweeseJAMahoneyEBRobCG. Intermittent subclavian vein obstruction without thrombosis. Surgery. 1968;68:147–165.
36.
AdamsJTDeweeseJAMahoneyEBRobCG. Primary deep venous thrombosis of uper extremity. Arch Surg. 1965;91:29–42.
37.
ZimmermannRMorlHHarenbergJGerhardtPKuhnHMWahlP. Urokinase therapy of subclavian-axillary vein thrombosis. Klin Wochenschr. 1981;59(15):851–856.
38.
GuzzoJLChangKDemosJBlackJHFreischlagJA. Preoperative thrombolysis and venoplasty affords no benefit in patency following first rib resection and scalenectomy for subacute and chronic subclavian vein thrombosis. J Vasc Surg. 2010;52(3):658–662.
39.
GharagozlooFMeyerMTempestaBJMargolisMStrotherETTummalaS. Robotic en bloc first-rib resection for Paget-Schroetter disease, a form of thoracic outlet syndrome: technique and initial results. Innovations (Phila). 2012;7(1):39–44.
40.
KreienbergPBChangBBDarlingRCIII. Long-term results in patients treated with thrombolysis, thoracic inlet decompression, and subclavian vein stenting for Paget-Schroetter syndrome. J Vasc Surg. 2001;33(2 suppl):S100–S105.
41.
LugoJTaniousAArmstrongP. Acute Paget-Schroetter syndrome: does the first rib routinely need to be removed after thrombolysis?Ann Vasc Surg. 2015;29(6):1073–1077.
42.
GrantJCB. A Method of Anatomy, Descriptive and Deductive3rd ed. Baltimore, MD: Williams and Wilkins Co; 1944.
43.
de SchepperA. “Nutcracker” phenomenon of the renal vein and venous pathology of the left kidney [in Dutch]. J Belge Radiol. 1972;55(5):507–511.
44.
GrimmLJEngstromBINelsonRCKimCY. Incidental detection of nutcracker phenomenon on multidetector CT in an asymptomatic population: prevalence and associated findings. J Comput Assist Tomogr. 2013;37(3):415–418.
45.
BeinartCSnidermanKWTamuraSVaughanEDJrSosTA. Left renal vein to inferior vena cava pressure relationship in humans. J Urol. 1982;127(6):1070–1071.
46.
NishimuraYFushikiMYoshidaM. Left renal vein hypertension in patients with left renal bleeding of unknown origin. Radiology. 1986;160(3):663–667.
47.
ReedNRKalraMBowerTCVrtiskaTJRicottaJJIIGloviczkiP. Left renal vein transposition for nutcracker syndrome. J Vasc Surg. 2009;49(2):386–393.
48.
ScultetusAHVillavicencioJLGillespieDL. The nutcracker syndrome: its role in the pelvic venous disorders. J Vasc Surg. 2001;34(5):812–819.
49.
KurklinskyAKRookeTW. Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc. 2010;85(6):552–559.
50.
DickEABurnettCAnsteeAHamadyMBlackDGedroycWM. Time-resolved imaging of contrast kinetics three-dimensional (3D). Magnetic resonance venography in patients with pelvic congestion syndrome. Br J Radiol. 2010;83(994):882–887.
51.
WhiteJVRyjewskiCMessersmithRNSbranaFSchwartzLB. Left ovarian to left external iliac vein transposition for the treatment of nutcracker syndrome. J Vasc Surg Venous Lymphat Disord. 2016;4(1):114–118.
52.
HartungOGrisoliDBoufiM. Endovascular stenting in the treatment of pelvic vein congestion caused by nutcracker syndrome: lessons learned from the first five cases. J Vasc Surg. 2005;42(2):275–280.
53.
ErbenYGloviczkiPKalraM. Treatment of nutcracker syndrome with open and endovascular interventions. J Vasc Surg Venous Lymphat Disord. 2015;3(4):389–396.
54.
NesteMGNarasimhamDLBelcherKK. Endovascular stent placement as a treatment for renal venous hypertension. J Vasc Interv Radiol. 1996;7(6):859–861.
55.
ChenSZhangHShiHTianLJinWLiM. Endovascular stenting for treatment of nutcracker syndrome: report of 61 cases with long-term followup. J Urol. 2011;186(2):570–575.
56.
WangXZhangYLiCZhangH. Results of endovascular treatment for patients with nutcracker syndrome. J Vasc Surg. 2012;56(1):142–148.
57.
LoveJWWhelanTJ. Popliteal artery entrapment syndrome. Am J Surg. 1965;109:620–624.
58.
RichNMHughesCW. Popliteal artery and vein entrapment. Am J Surg. 1967;113(5):696–698.
59.
RichNMCollinsGJJrMcDonaldPTKozloffLClagettGPCollinsJT. Popliteal vascular entrapment. Its increasing interest. Arch Surg. 1979;114(12):1377–1384.
60.
GerkinTMBeebeHGWilliamsDMBloomJRWakefieldTW. Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency. J Vasc Surg. 1993;18(5):760–766.
61.
MisselbeckTDanglebenDCelaniV. Isolated popliteal vein entrapment by the popliteus muscle: a case report. Vasc Med. 2008;13(1):37–39.