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J Korean Soc Emerg Med > Volume 31(3); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(3): 298-304.
May-Thurner 증후군의 임상 양상과 급성 폐동맥 색전증과의 연관성
노윤채1, 이재백2, 진영호2, 정태오2, 조시온2, 김소은2, 이정문3, 윤재철2
1예수병원 응급의학과
2전북대학교병원 응급의학과
3전북대학교병원 외상팀
Clinical features of May-Thurner syndrome and its relationship with acute pulmonary embolism in patients with acute deep vein thrombosis
Yun Chae Noh1, Jae Baek Lee2, Young Ho Jin2, Tae Oh Jeong2, Si On Jo2, So Eun Kim2, Jeong Moon Lee3, Jae Chol Yoon2
1Department of Emergency Medicine, Presbyterian Medical Center, Jeonju, Korea
2Department of Emergency Medicine, Jeonbuk National University Hospital, Jeonju, Korea
3Trauma Team, Jeonbuk National University Hospital, Jeonju, Korea
Correspondence  Jae Chol Yoon ,Tel: 063-250-1075, Fax: 063-250-1075, Email: jcyoon75@jbnu.ac.kr,
Received: October 10, 2019; Revised: November 5, 2019   Accepted: November 8, 2019.  Published online: June 25, 2020.
May-Thurner syndrome (MTS) is a condition, in which the left common iliac vein is compressed by the right common iliac artery and spine, resulting in an increased risk of deep vein thrombosis (DVT). This study examined the clinical features of MTS and relationship of MTS with a pulmonary embolism (PE) in acute DVT patients.
This study was a retrospective observational study using the electronic medical records of patients with acute DVT in 2018. Acute DVT patients were divided into the MTS group (n=18, 23.1%) and non-MTS group (n=60, 76.9%) according to the presence of MTS. The following items were compared: demographic data, risk factors of DVT, vital signs, laboratory results, involvement site of vein, incidence of PE, and severity of PE.
The presence of risk factors was similar in the two groups. All MTS patients had DVT in the left lower extremity. The ilio-femoral DVT (21.7% vs. 77.8%, P<0.001) and mixed DVT (both ilio-femoral and femoro-popliteal, 10.0% vs. 44.4%; P=0.002) were observed more frequently in the MTS group. The incidence of PE was higher in the non-MTS group (65.0%) than in the MTS group (33.3%) (P=0.017). On the other hand, the severity of PE assessed with main pulmonary artery involvement or hemodynamic instability, and right ventricular dysfunction did not show a significant difference between the two groups.
DVT could develop with the presence of risk factors in MTS patients. DVT patients with MTS might reduce the risk of developing PE compared to those without MTS, but the severity of PE was similar in the two groups.
Key words: Iliac vein compression; Deep vein thrombosis; Pulmonary embolism
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