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Spontaneous rupture of the left common iliac vein associated with May–Thurner syndrome: successful management with surgery and placement of an endovascular stent

Departments of ¹ Diagnostic Radiology and ² Vascular Surgery, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Republic of Korea

View larger version (69K): [in this window] [in a new window]   Figure 1. A 60-year-old woman with sudden onset of left lower abdominal pain. (a) Abdominal CT scan at the level of the common iliac vein reveals a large retroperitoneal haematoma (arrow) contiguous to the thrombosed left common iliac vein. (b) CT scan with curved planar reformation along the left common iliac vein course reveals extrinsic compression of the left common iliac vein between the fifth lumbar vertebra and right common iliac artery (short arrow) and acute thrombosis in the deep veins of the left lower extremity (long arrow). (c) Operative photogram shows a tear of approximately 1.2 cm at the anteromedial wall of the left common iliac vein (arrow). (d) Venogram obtained after placement of a stent reveals restoration of venous patency. (e) Follow-up CT scan with curved planar reformation obtained 8 months after treatment demonstrates a venous stent between the distal inferior vena cava and left common iliac vein with preserved luminal patency represented by proximal and distal venous flow.