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Because of its similarities to deep vein thrombosis (DVT), May–Thurner syndrome is rarely diagnosed amongst the general population. In this condition, the right iliac artery sequesters and compresses the left common iliac vein against the lumbar section of the spine, [5] resulting in swelling of the legs and ankles, pain, tingling, and/or numbness in the legs and feet. [6]
Treatment involves revascularization typically using either angioplasty or a type of vascular bypass [citation needed]. Kissing balloon angioplasty +/- stent, so named because the two common iliac stents touch each other in the distal aorta.
Nonthrombotic iliac vein lesions (NIVL) include May-Thurner Syndrome (MTS) whereby there is compression of the left iliac venous outflow usually by the right iliac artery leading to left leg discomfort, pain, swelling and varicose veins. NIVL encompasses compression of the iliac veins on either the right or left side. [25]
PCD results from extensive thrombotic occlusion (blockage by a thrombus) of extremity veins, most commonly an iliofemoral DVT, of the iliac vein and/or common femoral vein. [2] [3] It is a medical emergency requiring immediate evaluation and treatment.
The aortic bifurcation is the point at which the abdominal aorta bifurcates (forks) into the left and right common iliac arteries. The aortic bifurcation is usually seen at the level of L4, [1] just above the junction of the left and right common iliac veins. The right common iliac artery passes in front of the left common iliac vein.
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra . It ends in front of the sacroiliac joint , one on either side, and each bifurcates into the external and internal iliac arteries .
The lengths of the common iliac and internal iliac arteries bear an inverse proportion to each other, the internal iliac artery being long when the common iliac is short, and vice versa. The place of division of the internal iliac artery varies between the upper margin of the sacrum and the upper border of the greater sciatic foramen.
The superior, of large size, passes medialward, and, after anastomosing with branches from the middle sacral, enters the first or second anterior sacral foramen, supplies branches to the contents of the sacral canal, and, escaping by the corresponding posterior sacral foramen, is distributed to the skin and muscles on the dorsum of the sacrum, anastomosing with the superior gluteal.
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