1. What is it?
Vascular compression syndromes are conditions in which an anatomical structure compresses a vein or an artery, hindering the flow of blood.
The best known are nutcracker syndrome (compression of the left renal vein in the aortomesenteric clamp), May-Thurner syndrome (compression of the left iliac vein between the lumbar vertebra and the right iliac artery) and median arcuate ligament syndrome (compression of the celiac trunk). They do not always have clinical consequences and are sometimes incidental findings on imaging tests.
2. Symptoms
Symptoms depend on the vessel that is compressed:
- Nutcracker: pain in the left flank, sometimes blood in the urine, pelvic varicose veins or pelvic pain.
- May-Thurner: swelling, pain, heaviness, congestion, varicose veins or thrombosis in one (left) leg.
- Median arcuate ligament: most often asymptomatic. Occasionally, abdominal pain or nausea, especially after meals, and weight loss.
3. Treatment
The approach depends on the specific syndrome and its clinical impact. It ranges from observation in mild cases to endovascular (minimally invasive) treatment or surgery. The first step is always an accurate diagnosis with imaging tests.
Frequently asked questions
What is nutcracker syndrome?
It is the compression of the left renal vein between two arteries. It can cause flank or abdominal pain and, at times, blood in the urine. It is diagnosed with imaging tests.
What about May-Thurner syndrome?
It is the compression of the left iliac vein, which can cause swelling, varicose veins or thrombosis in that leg. In selected cases it is treated with a stent to reopen the vein.
Why does it take so long to diagnose?
Because the symptoms are often mistaken for more common problems. When persistent discomfort has no clear explanation, a vascular assessment with imaging tests can identify the compression.
More information
Related articles about symptoms and questions on vascular compression syndromes.
- › Thoracic outlet syndrome: types, symptoms and warning signs Thoracic outlet syndrome compresses nerves or vessels between the collarbone and first rib. Learn the types, symptoms and when it's an emergency.
- › Nutcracker syndrome: what it is, symptoms and treatment Nutcracker syndrome compresses the left renal vein and can cause flank pain, blood in the urine or pelvic varicose veins. Diagnosis in Madrid.
- › May-Thurner syndrome: when the left leg swells May-Thurner syndrome compresses the left iliac vein and can cause swelling, varicose veins or thrombosis in that leg. Diagnosis and stent treatment.
- › Median arcuate ligament syndrome: pain after eating Median arcuate ligament syndrome compresses the celiac trunk. Often no symptoms; sometimes abdominal pain after eating. Diagnosis and treatment.
