title: Iliac vein compression syndrome from anterior perforation of a pedicle screw.
abstract: May-Thurner syndrome is an anatomic variant where the right common iliac artery compresses the left common iliac vein. The variant exists in a significant portion of the population, but is usually asymptomatic; however, clinically significant stenosis can occur by iatrogenic means. In this report, we describe a patient who presents with left lower extremity pain and swelling. Initial workup for deep vein thrombosis was negative. After being referred to our venous clinic, a magnetic resonance angiography revealed narrowing of the left common iliac vein with a tortuous right common iliac artery crossing over the constriction. During left iliac vein stent placement, a pedicle screw from a prior L2-S1 spinal fusion was noted to be perforated through L5 vertebral body impinging the posterior aspect of the vein. This case demonstrates that increased scrutiny must be applied when dealing with pathology in close proximity to any implanted medical device.
authors.affiliation: Department of Surgery, Michigan State University, Lansing, MI, USA jaesungw@gmail.com.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Woo
authors.affiliation: Department of Radiology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Ogilvie
authors.affiliation: School of Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Van Schaumburg
authors.initials: VS
authors.lastname: Krueger
authors.affiliation: Department of Surgery, Michigan State University, Lansing, MI, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lundin
authors.affiliation: Department of Interventional Radiology, University of Michigan Cardiovascular Center, Ann Arbor, MI, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Williams