Abstract 3088: Inferior Vena Cava (IVC) Thrombosis In A Patient With May Thurner Syndrome: A Rare Case Of Thrombotic Iliocaval Obstruction In Octogenarian Population.

Abstract

Introduction: May Thurner Syndrome is an extrinsic compression of the left common iliac vein by the right common iliac artery against lumbar spine. It is a rare cause of the lower extremity deep venous thrombosis (DVT) in octogenarian population. There is barely any data to document the association of IVC thrombosis with May Thurner Syndrome. Blood stasis in the setting of venous compression can increase the risk for DVT distally but proximal DVT is rare in absence of any other risk factors of thromboembolism. Case Representation: We present a unique case of 86-year-old female who was incidentally diagnosed with IVC thrombosis, left common iliac vein thrombosis, and left sided May Thurner Syndrome that is never documented before in octogenarian population. She had IVC thrombosis extending to the left common iliac vein with extrinsic compression by the right common iliac artery. This case is unique as our patient did not have any risk factor for venous thrombosis other than May Thurner Syndrome. Conclusion: May Thurner Syndrome can increase the risk for DVT proximal propagation and IVC thrombosis. The management of IVC thrombosis and May Thurner Syndrome in octogenarian population needs to account for risk of pulmonary embolism and mortality when avoiding anticoagulation compared to risk of morbidity and mortality from bleeding with anticoagulation. The decision to further manage depends upon clinical features, risk factors and institutional resources.