Classic presentation and treatment of May-Thurner syndrome

This female in her twenties presented with extensive acute left lower extremity swelling and tenderness.
(A) Extensive left iliofemoral DVT was diagnosed on venous duplex ultrasound and confirmed on venography. After 36 hours of thrombolytic therapy, the culprit lesion of the left iliac vein was revealed (arrow).
(B) An IVUS catheter (0.035 system) was used to evaluate the ongoing response to lytic therapy.
(C) Angioplasty and stenting of stenosed left iliac vein was performed using a self-expanding stent with full resolution on completion venogram (arrow).