Extrinsic vascular compression is caused by neighboring structures compressing veins in confined anatomic areas, and it can be found in a variety of places. Paget–Schroetter syndrome, Nutcracker syndrome, May–Thurner syndrome, and popliteal venous compression are all vascular compression disorders that will be discussed. These syndromes are most common in young, otherwise healthy people, and they can cause severe morbidity. Ultrasound, CT, or MR conventional venography can be used to make a diagnosis in addition to clinical findings and physical examination. The appropriate treatment technique is determined by the symptoms and hemodynamic importance of the compression.
Vascular compression syndromes are a rare type of venous compression condition characterized by anatomical extrinsic venous compression in otherwise healthy young people. While they are infrequent, they can result in serious problems such as discomfort, edema, DVT, pulmonary embolism, and post-thrombotic syndrome. May-Thurner syndrome (MTS), variant iliac vein compression syndrome (IVCS), venous thoracic outlet syndrome (VTOS)/Paget-Schroetter syndrome, nutcracker syndrome (NCS), and popliteal venous compression syndrome (PVCs) are the most common disease entities (PVC). The important clinical aspects, multimodality imaging results, and therapy options for various illnesses are discussed in this article. The importance of noninvasive imaging methods like magnetic resonance venography (MRV) in aiding early and accurate diagnosis and personalized treatments is highlighted.
The extrinsic mass effect of surrounding structures such as arteries, bones, muscles, or ligaments on a vein causes vascular compression syndromes. The otherwise morphologically normal vein becomes caught between rigid or semi-rigid surfaces in a tight and constrained anatomic region, which is frequently due to an underlying anatomic defect. The development of these illnesses is likewise linked to repetitive microtrauma that causes endothelial damage at the site of external vascular compression.
Venous compression symptoms are uncommon; in fact, vascular entrapment (venous or arterial) affects less than 1% of the population. However, venous stasis, insufficiency, or thrombosis are serious and debilitating problems. Furthermore, these diseases disproportionately affect less than 1% of healthy patients, who are the most likely to benefit from quick and successful treatment in the long run.
Many patients are asymptomatic, and when symptoms such as pain, edema, or hematuria do appear, they are often vague and ambiguous, resulting in delayed or misdiagnosed. Clinical signs are frequently delayed until the pressure in the affected vein rises or changes flow direction, resulting in the creation of venous collateral and varicosities, as well as the possibility of acute deep vein thrombosis. On the same hand, patients who are identified to have anatomical features that predispose to venous compression but are otherwise asymptomatic should not be overdiagnosed or treated.
The most common syndromes for Venous compression are:
The compression of the left renal vein between the aorta and mesenteric arteries causes Nutcracker Syndrome in the abdomen. It might be asymptomatic or produce haematuria (blood in the urine), flank pain, pelvic pain, and varicocele, among other things (testicular varicose veins or veins around the ovary).
An expert practitioner's assessment and management are required. Some patients may not require any treatment at all.Popliteal Vein Compression Syndrome
Soft tissue around the knee may put a strain on the popliteal vein (the vein behind the knee), resulting in varicose veins or venous symptoms. It affects almost a quarter of our population.
It might be asymptomatic or produce pain, edema, varicose veins, or deep venous thrombosis (blood clot), among other things. Failure of varicose vein treatment can be caused by undiagnosed popliteal vein compression syndrome. It's critical to see a skilled phlebologist or vein specialist.
An expert practitioner's assessment and management are required. Some patients may not require any treatment at all.May-Thurner Syndrome
Between the right common iliac artery and the sacrum, the left iliac vein (located in the pelvis and serving as the common outflow tract of the lower limb extremities) is compressed. Pain, swelling, discomfort, and deep venous thrombosis are all possible side effects (blood clots). An expert practitioner's assessment and management are required.Venous Malformations
Venous lesion(s) are improperly developed dilated veins that have been present since birth. These lesions are most commonly found on the skin, although they can also be found in internal organs, muscles, and bones. Symptoms range from asymptomatic (no symptoms) to severe (pain, bleeding, and discomfort).
The lesion gets worse as the person gets older. Malformations are difficult medical conditions to deal with. Depending on the size and location of the lesions, they can be treated in an outpatient environment by an expert phlebologist or health practitioner, or they may require inpatient assessment and treatment by a team of specialists.