36 year old female with a left lower extremity iliofemoral deep venous thrombosis (DVT) and pulmonary embolism (PE) 9 years prior. Increasing problems with left leg venous claudication with exercise. Symptoms limiting the patients ability to be active. MR venography showed occlusion of the left iliac venous system typical of May Thurner syndrome or iliac vein compression syndrome. Stenting and venoplasty was performed with complete resolution of symptoms.
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.
Renal vein stent placed for Nutracker Syndrome was placed too far into the IVC and causing pain. Stent was partially removed.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.