Leg Swelling / May-Thurner Syndrome

Bloomfield Vein & Vascular

Leg Swelling / May-Thurner Syndrome


Do you experience leg swelling? Do you feel that one leg is larger or more swollen than the other? Have you noticed that even after you elevate your leg(s), the swelling quickly returns?

If so, you may be experiencing a condition known as Iliac Vein Compression Syndrome, sometimes referred to as May-Thurner Syndrome. This condition tends to cause discomfort, swelling and/or varicose veins usually involving one lower extremity, typically the LEFT. However, it is not uncommon for BOTH lower extremities to be affected

If you believe that you may have this problem, please let us evaluate you. Leg pain is not normal, and swelling is a sign that something is wrong. However, this can be a complex matter and as a Board Certified Vascular Surgeon I am in an unique position to help you.

If you have been evaluated by a different “vein center,” please feel free to seek a second opinion from us. We often find that these centers do not do a thorough enough job of diagnosing your problem. And more importantly, they usually do not have the ability to treat you. We are recognized in the Metro Detroit area as the center with the most experience and expertise dealing with this condition. We have helped hundreds of patients with this problem, restoring their legs back to normal and allowing them to enjoy life without the long-term consequences of this condition.



  • Leg swelling, particularly if one leg is larger than the other
  • Achiness, heaviness and tiredness
  • Varicose veins that are located in the upper thigh
  • Pain with prolonged standing or even weakness of the leg with standing or walking



  • A thorough physical exam
  • A special abdominal ultrasound



Iliac compression syndrome is a complex problem. Diagnosis is dependent upon a number of factors. If after appropriate testing and examination, we feel that you have this condition, we typically suggest a venogram, a special picture of your veins. At the time of the procedure, we use Intravascular Ultrasound (IVUS) to help us decide as to whether treatment is indicated. If so, a special stent is introduced. This is all minimally invasive and does not involve any surgery (see videos below).

This procedure is performed at our state of the art office. You can go home the same day and you can resume your daily activities the next day. We specialize in this condition. Our expertise will be evident when you are evaluated at Bloomfield Vein and Vascular.

No other center in Metro Detroit has as much experience in treating this condition as the staff at Bloomfield Vein and Vascular.

The image above shows the two types of blood vessels in our bodies: veins in blue and arteries in red. As you can see, the arteries cross the veins at different points (circles). Arteries are muscular and strong, whereas veins are thinner and can be compressed or “squished.” When our heart beats, it makes the arteries beat as well. The veins in our pelvis (the region of our body shown on this image) are “sandwiched” between a beating artery and bone (see caption).

Over time, the constant beating of the artery on top of the vein can lead to scarring of the vein. This external compression causes the vein to change from an open pipe to a narrowed pipe, like an “hourglass,” underneath the beating artery. As the blood flow from our legs tries to go through these areas of compression, it slows down and backs up. In rare circumstances, it can lead to a blood clot (DVT). When blood backs up, it will flow towards your feet and might lead to swelling and symptoms of achiness, heaviness, tiredness, thigh tightness and sometimes pain when walking.

This is an ultrasound image of the RIGHT (RT) External Iliac Vein (EIV), with measurements as noted on the right corner. Typically, the vein should measure 9 – 13 mm; in this patient, the vein is narrowed to 3.8 – 4.4 mm. This decreased size is due to compression by the artery overlying it (see next image).


This video shows active compression of the EIV by the artery that overlies it. This results in scarring of the vein and eventual narrowing of the vein, which impairs flow.

Treatment of May-Thurner I – Venogram

Treatment of May Thurner Syndrome -the use of Intravascular Ultrasound (IVUS)

Schedule An Appointment With Dr. Diego Hernandez

43700 Woodward Ave., Suite 207, Bloomfield Hills, MI.
Office Hours

Monday – Thursday: 7:30 a.m. to 4:30 p.m.
Friday: 7:30 a.m. to 12 noon
The office is closed for lunch between 12 noon – 1 p.m., everyday.