May-Thurner Syndrome

A Hidden Condition That Can Go
Undetected Even With Advanced Imaging

What is May-Thurner Syndrome?

There are two main blood vessels in your legs – the iliac vein and iliac artery. May-Thurner Syndrome is a condition that causes the right iliac artery to press against the left iliac vein in the pelvis, narrowing the vessel. Often, there are no symptoms. The reduced blood flow can cause clots and Deep Vein Thrombosis (DVT).

Causes & Risk Factors

The primary cause of May-Thurner Syndrome is anatomical; the right iliac artery crosses over the left iliac vein, potentially compressing it. Certain factors might increase the risk, including: Prolonged periods of inactivity or immobilization. A history of vascular issues or clotting disorders. Hormonal factors, such as pregnancy or the use of birth control pills, which can increase blood clotting tendencies.


Diagnosis of May-Thurner Syndrome typically involves imaging studies to view the blood vessels and assess any obstructions or compressions. These might include:
  • Venography: A dye is injected into the veins to provide a clear view of the veins and any blockages.
  • Ultrasound: Used to visualize blood flow and detect clots.
  • CT or MRI scans: Provide detailed images of the vascular anatomy and can help identify the compression.


The treatment for May-Thurner Syndrome focuses on managing symptoms and preventing complications, such as DVT. Treatment options may include:
  • Blood thinners (anticoagulants) to prevent clot formation.
  • Stenting to open up the compressed vein and restore normal blood flow.
  • Compression stockings to help reduce swelling and improve blood flow.
For individuals diagnosed with May-Thurner Syndrome, ongoing monitoring and follow-up care with a vascular specialist are essential to manage the condition and prevent serious complications.

Symptoms of May-Thurner Syndrome

  • Pain, swelling, tenderness
  • Throbbing in the lower leg, usually worse on the left
  • Potentially lower back pain
  • Sensation of warmth
  • Skin discoloration, especially at the ankles
  • One leg is larger than the other
  • Varicose veins in the pelvic area

Symptoms of PTS

Fortunately, May-Thurner Syndrome is easy to treat. Using our intravascular ultrasound (IVUS), we locate the affected area, and insert a tiny balloon to open the vein and restore blood flow. We insert a small stent or metal mesh tube to keep it open.

Outcomes are excellent for this procedure, especially when performed early, before blood clots form.

Concerned You May Have May-Thurner Syndrome?

Many people don’t realize they have May-Thurner Syndrome until it leads to DVT. We can screen for DVT with an MRI or CT scan.

Get Treated Sooner

Because we’re highly specialized in treating May-Thurner Syndrome, with seven treatment locations in the St. Louis area, we’re able to schedule your exam and treatment much sooner than other facilities. Call us at 314-849-0923 or complete this contact form to get started.

Schedule a Consultation

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What To Expect


Dr. Krikorain will examine your legs and feet. We’ll provide shorts to wear during the exam, if needed. You may have an ultrasound, also known as a VRS (venous reflux study), and we may schedule you for further testing.


Treatment for May-Thurner Syndrome will be stent placement at one of our outpatient surgery centers.


You will have 3-5 days of lifting restrictions, and we’ll prescribe a blood thinner short term.

"No More Pain"

MaryAnn R.

My daughter could not believe how good my legs looked! She is going to see Dr. Krikorian too. I was completely satisfied with my treatment and am no longer in pain. The result is fantastic and I highly recommend going to see Dr. Krikorian if you are experiencing any leg pain.

"I Walked 2 Miles the Next Day!"

Shirley M.

I had suffered with varicose veins for years. I recently went to see Dr. Krikorian at Virtue Vein & Lymphatic Center where he told me everything I needed to know about vein disease and the treatment options. He performed a laser ablation on my diseased vein, and I was able to resume my normal activity the day after my procedure!

"They Listen Very Well!"

Jeff K.

Dr. Krikorian is a busy man, but he will take the time necessary to really listen to you and figure out what the problem is. Most doctors these days seem to be talking to the computer, and not the person. Well, here it is the other way around.

"Very Knowledgable!"

Happy Patient

After my stress test was normal, Dr. Krikorian explained that the test was around 70% accurate and that I should pay close attention to my body for any warning signs. A few weeks later I was exercising when my energy was zapped in less than 10 minutes and I had a pain under the sternum. I called Dr. Krikorian and he scheduled a cardiac catheterization the next day. He said I showed no sign of a heart attack but he found a 99% blockage in the circumflex artery, which he opened with a stent. I am grateful that he explained possible warning signs and then responded quickly with the catheterization and stent.

"My Leg is Feeling So Much Better!"

Marlene G.

Dr. Krikorian performed a laser ablation to treat the vein disease in my right leg. I didn’t even realize how much my left leg hurt from varicose veins until he fixed my right leg! I thought the treatment would be painful, so I was so pleasantly surprised to find that it wasn’t.

May-Thurner Syndrome FAQ

Am I at risk for May-Thurner Syndrome?

You are most at risk if you’re female, between the ages of 24-40. If you’ve recently given birth, especially to twins or more, or are on oral contraceptives, you have an elevated risk. Other risks include dehydration, hypercoagulable disorders, and cumulative radiation exposure.

Is this treatment covered by insurance?

This is a medical condition, so most insurances cover treatment.

Does the treatment hurt?

If you get a stent, you may have low back or hip pain for 2-3 weeks following the procedure.

Does May-Thurner Syndrome come back after treatment?

This syndrome/symptoms of this syndrome may return if there is re-narrowing of the stent or if there is medication noncompliance.

Is there a way to prevent May-Thurner Syndrome?

No, unfortunately, this condition is genetic.

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