Evolving Concepts in the Diagnosis and Management of May–Thurner Syndrome

May–Thurner syndrome (MTS) is caused by compression of the left common iliac vein by the right common iliac artery, resulting in symptoms of venous obstruction, insufficiency, and thrombosis. It is also known as iliac vein compression syndrome or Cockett’s syndrome.1 McMurrich initially reported association of common iliac vein compression with increased incidence of left lower extremity deep vein thrombus, thought to be congenital.2 Ehrich postulated acquired degenerative obstruction at the origin of the left common iliac vein.3 Subsequently, Mayand Thurner described compression of the left common iliac vein from the right common iliac artery, resulting in mural spur formation.4